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General NPI Number Information
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NPI Number | 1376488098
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Entity Type | Organization
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Legal Business Name | 412374224
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Dates
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Enumeration Date | 04/20/2026
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Last Update Date | 04/20/2026
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Provider Practice Location Address
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Address Line | 910 JOHN ST
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City | SEATTLE
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State | WA
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Zip | 98109-5213
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Country | US
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Telephone | 800-444-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 910 JOHN ST
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City | SEATTLE
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State | WA
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Zip | 98109-5213
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER MD
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Name | MICHAEL TEE
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Credential | MD
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Telephone | 503-259-9888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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