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General NPI Number Information
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NPI Number | 1417505454
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Entity Type | Organization
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Legal Business Name | HOUSE, LEE, MAST, MCDONALD AND NELSON, PC
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Dates
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Enumeration Date | 09/03/2019
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 2743 CALIFORNIA AVE SW UNIT 201
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City | SEATTLE
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State | WA
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Zip | 98116-2495
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Country | US
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Telephone | 206-935-2414
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Fax |
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Provider Business Mailing Address
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Address Line | 2743 CALIFORNIA AVE SW UNIT 201
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City | SEATTLE
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State | WA
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Zip | 98116-2495
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Country | US
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Telephone | 206-935-2414
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | LANETTE MCINTOSH
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Credential |
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Telephone | 425-233-0971
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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