=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558453944
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HENRY K. YEE MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/29/2006
-----------------------------------------------------
Last Update Date | 09/27/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 205 S MAIN ST STE A
-----------------------------------------------------
City | COUPEVILLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98239-3635
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-240-4013
-----------------------------------------------------
Fax | 360-678-5161
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4348 WAIALAE AVE
-----------------------------------------------------
City | HONOLULU
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96816-5767
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-262-6260
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207X00000X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Surgery Physician
-----------------------------------------------------
License Number | MD-4727
-----------------------------------------------------
License Number State | HI
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207X00000X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Surgery Physician
-----------------------------------------------------
License Number | MD00017445
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------