Healthcare Provider Details

I. General information

NPI: 1700339892
Provider Name (Legal Business Name): STANLEY LEE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2016
Last Update Date: 02/06/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 W 8TH AVE STE 660E
SPOKANE WA
99204-2302
US

IV. Provider business mailing address

105 W 8TH AVE STE 660E
SPOKANE WA
99204-2302
US

V. Phone/Fax

Practice location:
  • Phone: 509-474-6960
  • Fax:
Mailing address:
  • Phone: 509-474-6960
  • Fax: 509-227-7070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD61306464
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License NumberMD61306464
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: