Healthcare Provider Details
I. General information
NPI: 1932043007
Provider Name (Legal Business Name): SARAH KYUNGEN LEE RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/17/2026
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
16330 SE 256TH ST
COVINGTON WA
98042-4233
US
IV. Provider business mailing address
32602 10TH PL SW
FEDERAL WAY WA
98023-4900
US
V. Phone/Fax
- Phone: 253-246-7403
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 124Q00000X |
| Taxonomy | Dental Hygienist |
| License Number | |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: