Healthcare Provider Details

I. General information

NPI: 1609949072
Provider Name (Legal Business Name): PAULINE LEE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3550 FACTORIA BLVD SE
BELLEVUE WA
98006-6126
US

IV. Provider business mailing address

16072 RESERVE DR SE
NORTH BEND WA
98045-6201
US

V. Phone/Fax

Practice location:
  • Phone: 425-378-0202
  • Fax: 425-378-0225
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPH00064203
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: