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General NPI Number Information
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NPI Number | 1083029995
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Entity Type | Individual
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Provider Name | EDWARD LEE DPM
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Gender | Male
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Dates
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Enumeration Date | 06/30/2014
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Last Update Date | 09/23/2021
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Provider Practice Location Address
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Address Line | 206 AUBURN AVE
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City | AUBURN
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State | WA
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Zip | 98002-5015
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Country | US
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Telephone | 253-245-9299
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Fax | 253-604-1259
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Provider Business Mailing Address
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Address Line | 206 AUBURN AVE
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City | AUBURN
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State | WA
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Zip | 98002-5015
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Country | US
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Telephone | 253-245-9299
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Fax | 253-604-1259
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 2300
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License Number State | TX
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