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General NPI Number Information
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NPI Number | 1316152168
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Entity Type | Individual
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Provider Name | DALE KYU LEE FNP, NP-C
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Gender | Male
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 9427 SW BARNES RD STE 296
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City | PORTLAND
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State | OR
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Zip | 97225-6667
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Country | US
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Telephone | 503-297-3778
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Fax | 503-297-7853
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Provider Business Mailing Address
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Address Line | 541 NE 20TH AVE STE 225
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City | PORTLAND
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State | OR
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Zip | 97232-2895
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Country | US
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Telephone | 503-963-2801
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Fax | 503-963-2825
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 201709198NP-PP
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 60799785
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 201242543RN
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License Number State | OR
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