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General NPI Number Information
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NPI Number | 1386219244
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Entity Type | Organization
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Legal Business Name | SASHA LEE INC
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Dates
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Enumeration Date | 05/24/2021
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Last Update Date | 05/24/2021
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Provider Practice Location Address
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Address Line | 4966 EUCLID RD STE 106
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-5834
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Country | US
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Telephone | 757-679-0361
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Fax | 757-908-2223
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Provider Business Mailing Address
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Address Line | 4966 EUCLID RD STE 106
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-5834
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Country | US
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Telephone | 757-679-0361
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Fax | 757-908-2223
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Authorized Official
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Title or Position | NURSE PRACTITIONER/OWNER
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Name | SASHA LEE
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Credential | NURSE PRACTITIONER
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Telephone | 757-679-0361
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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