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General NPI Number Information
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NPI Number | 1871812818
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Entity Type | Individual
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Provider Name | CHRISTIE KIM LEE D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/28/2010
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Last Update Date | 05/31/2023
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Provider Practice Location Address
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Address Line | 10032 EDMONDS WAY STE 102
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City | EDMONDS
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State | WA
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Zip | 98020-5169
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Country | US
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Telephone | 425-202-5877
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Fax |
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Provider Business Mailing Address
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Address Line | 6536 55TH AVE NE
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City | SEATTLE
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State | WA
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Zip | 98115-7825
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Country | US
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Telephone | 703-447-5597
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 60465465
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License Number State | WA
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