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General NPI Number Information
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NPI Number | 1588763494
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Entity Type | Organization
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Legal Business Name | WASHINGTON PACIFIC EYE ASSOCIATES INC.
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 08/31/2011
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Provider Practice Location Address
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Address Line | 134 CENTRAL WAY
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City | KIRKLAND
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State | WA
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Zip | 98033-6106
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Country | US
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Telephone | 425-889-2020
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Fax | 425-734-0601
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Provider Business Mailing Address
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Address Line | 134 CENTRAL WAY
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City | KIRKLAND
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State | WA
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Zip | 98033-6106
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Country | US
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Telephone | 425-889-2020
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Fax | 425-734-0601
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. JENNIFER JUNG YUN LEE
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Credential | M.D.
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Telephone | 425-889-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MD 00043816
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License Number State | WA
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