Healthcare Provider Details

I. General information

NPI: 1811794837
Provider Name (Legal Business Name): JUNGYEON LEE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RACHEL LEE

II. Dates (important events)

Enumeration Date: 02/27/2025
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1959 NE PACIFIC ST
SEATTLE WA
98195-0001
US

IV. Provider business mailing address

1959 NE PACIFIC ST
SEATTLE WA
98195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 206-543-8736
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License NumberARNP.AP.70172559-NP
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: