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General NPI Number Information
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NPI Number | 1639000128
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Entity Type | Individual
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Provider Name | JACQUELINE LEE
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Gender | Female
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Dates
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Enumeration Date | 05/26/2026
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Last Update Date | 05/26/2026
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Provider Practice Location Address
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Address Line | 2318 HERITAGE WAY SE
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City | ALBANY
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State | OR
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Zip | 97322-8600
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Country | US
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Telephone | 541-926-8092
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Fax | 541-967-7072
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Provider Business Mailing Address
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Address Line | 2156 N HILL FIELD RD STE 3
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City | LAYTON
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State | UT
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Zip | 84041-4780
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Country | US
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Telephone | 801-203-4055
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Fax | 801-252-5681
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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 | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 10252806
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License Number State | OR
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