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General NPI Number Information
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NPI Number | 1609670041
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Entity Type | Individual
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Provider Name | HEEJUNG LEE
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Gender | Male
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Dates
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Enumeration Date | 04/03/2025
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Last Update Date | 04/03/2025
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Provider Practice Location Address
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Address Line | 1 CVS DR
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City | WOONSOCKET
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State | RI
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Zip | 02895-6146
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Country | US
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Telephone | 401-765-1500
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Fax |
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Provider Business Mailing Address
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Address Line | 13800 NEWCASTLE GOLF CLUB RD APT 225
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City | NEWCASTLE
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State | WA
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Zip | 98059-3309
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Country | US
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Telephone | 774-325-6003
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH61452661
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License Number State | WA
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