Healthcare Provider Details

I. General information

NPI: 1104738079
Provider Name (Legal Business Name): REBECCA LYNN LEE LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18920 BOTHELL WAY NE STE 204
BOTHELL WA
98011-1981
US

IV. Provider business mailing address

12701 NE 130TH CT APT A102
KIRKLAND WA
98034-3237
US

V. Phone/Fax

Practice location:
  • Phone: 425-424-3730
  • Fax:
Mailing address:
  • Phone: 425-623-8788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMASS.MA.70177695
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: