Healthcare Provider Details

I. General information

NPI: 1184232068
Provider Name (Legal Business Name): LUCY HYERIN LEE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HYERIN LEE

II. Dates (important events)

Enumeration Date: 07/16/2020
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date: 07/03/2024
Reactivation Date: 11/04/2024

III. Provider practice location address

222 W MISSION AVE STE 122
SPOKANE WA
99201-2345
US

IV. Provider business mailing address

222 W MISSION AVE STE 122
SPOKANE WA
99201-2345
US

V. Phone/Fax

Practice location:
  • Phone: 509-842-0067
  • Fax:
Mailing address:
  • Phone: 509-842-0067
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: