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General NPI Number Information
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NPI Number | 1134674369
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Entity Type | Organization
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Legal Business Name | STEVE LEE
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Dates
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Enumeration Date | 08/17/2016
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Last Update Date | 08/17/2016
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Provider Practice Location Address
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Address Line | 1620 DUVALL AVE NE STE A
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City | RENTON
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State | WA
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Zip | 98059-3975
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Country | US
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Telephone | 425-271-6002
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Fax | 425-271-6314
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Provider Business Mailing Address
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Address Line | 1620 DUVALL AVE NE STE A
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City | RENTON
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State | WA
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Zip | 98059-3975
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Country | US
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Telephone | 425-271-6002
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Fax | 425-271-6314
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Authorized Official
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Title or Position | DENTIST
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Name | MR. STEVEN RAYMOND LEE
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Credential | DDS
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Telephone | 425-271-6002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 5451
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License Number State | WA
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