Healthcare Provider Details

I. General information

NPI: 1689058075
Provider Name (Legal Business Name): DANIELLE K YEE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2015
Last Update Date: 08/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 COLLEGE ST SE
LACEY WA
98503
US

IV. Provider business mailing address

PO BOX 3360
PORTLAND OR
97208-3360
US

V. Phone/Fax

Practice location:
  • Phone: 360-486-2900
  • Fax: 360-486-2901
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD60770421
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: