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General NPI Number Information
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NPI Number | 1326574203
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Entity Type | Individual
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Provider Name | EUGENE YUNSUNG LEE D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 05/11/2017
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 4004 KRUSE WAY PL STE 125
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City | LAKE OSWEGO
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State | OR
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Zip | 97035-2493
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Country | US
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Telephone | 650-430-7099
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Fax |
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Provider Business Mailing Address
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Address Line | 3570 S RIVER PKWY UNIT 1611
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City | PORTLAND
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State | OR
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Zip | 97239-4544
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Country | US
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Telephone | 650-430-7099
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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 | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | D12261
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 105703
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License Number State | CA
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