Healthcare Provider Details

I. General information

NPI: 1942126099
Provider Name (Legal Business Name): SALENA LEE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2511 GREEN BAY ST
LA CROSSE WI
54601-5900
US

IV. Provider business mailing address

3322 29TH ST S
LA CROSSE WI
54601-7914
US

V. Phone/Fax

Practice location:
  • Phone: 608-775-8585
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number23389-40
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: