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General NPI Number Information
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NPI Number | 1285900548
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Entity Type | Individual
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Provider Name | LOUIS KON-WAI LEE OD
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Gender | Male
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Dates
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Enumeration Date | 03/30/2012
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 1500 109TH AVE NE
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City | BLAINE
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State | MN
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Zip | 55449-4670
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Country | US
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Telephone | 763-354-1003
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Fax | 763-354-1005
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Provider Business Mailing Address
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Address Line | 778 PARKSIDE LN
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City | COLUMBIA HEIGHTS
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State | MN
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Zip | 55421-5001
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Country | US
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Telephone | 415-336-9328
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Fax |
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 3266
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License Number State | MN
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