Healthcare Provider Details

I. General information

NPI: 1043305600
Provider Name (Legal Business Name): YOO-LEE YEA DDS, MSD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 EAST YESLER WAY ODESSA BROWN CHILDREN'S CLINIC SUITE 100
SEATTLE WA
98122-5999
US

IV. Provider business mailing address

2101 EAST YESLER WAY ODESSA BROWN CHILDREN'S CLINIC SUITE 100
SEATTLE WA
98122-5999
US

V. Phone/Fax

Practice location:
  • Phone: 206-987-7254
  • Fax: 206-987-7206
Mailing address:
  • Phone: 206-987-7254
  • Fax: 206-987-7206

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDE00009955
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: