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General NPI Number Information
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NPI Number | 1902692197
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Entity Type | Individual
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Provider Name | JAMES LEE SIMON LMT
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Gender | Male
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Dates
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Enumeration Date | 04/16/2025
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 13353 NE BEL RED RD STE 103
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City | BELLEVUE
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State | WA
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Zip | 98005-2329
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Country | US
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Telephone | 425-679-5996
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Fax |
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Provider Business Mailing Address
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Address Line | 950 HARRINGTON AVE NE APT S409
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City | RENTON
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State | WA
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Zip | 98056-3479
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Country | US
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Telephone | 206-474-6696
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 61583726
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License Number State | WA
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