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General NPI Number Information
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NPI Number | 1629237268
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Entity Type | Individual
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Provider Name | CHAN H LEE MD
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Gender | Male
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Dates
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Enumeration Date | 06/09/2008
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Last Update Date | 06/16/2021
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Provider Practice Location Address
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Address Line | 914 S SCHEUBER RD PMG SW WA CENTRALIA ANESTHESIOLOGY
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City | CENTRALIA
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State | WA
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Zip | 98531-9027
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Country | US
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Telephone | 360-736-2803
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3360
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City | PORTLAND
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State | OR
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Zip | 97208-3360
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Country | US
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Telephone | 866-366-2983
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | MD60001650
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License Number State | WA
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