Healthcare Provider Details

I. General information

NPI: 1982653101
Provider Name (Legal Business Name): ELLYN LEE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2006
Last Update Date: 02/26/2026
Certification Date: 02/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 16TH AVE E
SEATTLE WA
98112-5226
US

IV. Provider business mailing address

201 16TH AVE E
SEATTLE WA
98112-5226
US

V. Phone/Fax

Practice location:
  • Phone: 206-326-3000
  • Fax: 877-515-2975
Mailing address:
  • Phone: 206-326-3000
  • Fax: 877-515-2975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number036-105594
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License NumberMD60455493
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: