Healthcare Provider Details

I. General information

NPI: 1194732610
Provider Name (Legal Business Name): MELISSA ANN LEE DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9714 3RD AVE NE SUITE 200
SEATTLE WA
98115-2044
US

IV. Provider business mailing address

9714 3RD AVE NE SUITE 200
SEATTLE WA
98115-2044
US

V. Phone/Fax

Practice location:
  • Phone: 206-523-7600
  • Fax:
Mailing address:
  • Phone: 206-523-7600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDENT.DE.00009097
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDENT.DE.00009097
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: