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General NPI Number Information
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NPI Number | 1477110385
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Entity Type | Individual
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Provider Name | ADRIAN LEE
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Gender | Female
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Dates
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Enumeration Date | 05/27/2019
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Last Update Date | 05/27/2019
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Provider Practice Location Address
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Address Line | 3719 88TH ST NE STE A
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City | MARYSVILLE
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State | WA
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Zip | 98270-7228
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Country | US
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Telephone | 360-659-9621
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Fax |
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Provider Business Mailing Address
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Address Line | 4223 CEDAR RIDGE DR
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City | GRAND PRAIRIE
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State | TX
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Zip | 75052-2819
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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 |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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