Healthcare Provider Details

I. General information

NPI: 1093629883
Provider Name (Legal Business Name): GRETCHEN LEA LEE RF
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 972
LA CENTER WA
98629-0972
US

IV. Provider business mailing address

PO BOX 972
LA CENTER WA
98629-0972
US

V. Phone/Fax

Practice location:
  • Phone: 360-901-6962
  • Fax:
Mailing address:
  • Phone: 360-901-6962
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173C00000X
TaxonomyReflexologist
License Number70145073
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: