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NPI Code Detail

MEDICARE: FAYZEL S LEE MD

MEDICARE: FAYZEL S LEE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology PhysicianMD00039339WA
2207L00000XAnesthesiology Physician100143WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164426698
Entity Type Code : Individual
Provider Name (Legal Business Name) : FAYZEL S LEE MD
Provider Business Mailing Address
First Line : PO BOX 97115
Second Line :
City : LAKEWOOD
State : WA
Zip : 98497-0115
Country : US
Telephone Number : 253-588-7911
Fax Number :
Provider Business Practice Location Address
First Line : 939 CAROLINE ST
Second Line :
City : PORT ANGELES
State : WA
Zip : 98362-3909
Country : US
Telephone Number : 360-417-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2005
Last Update Date : 02/01/2023

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