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NPI Code Detail

MEDICARE: SUE LEE

MEDICARE:   SUE  LEE
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
1363LF0000XFamily Nurse PractitionerAP61004485WA

General Provider Information

NPI Number : 1548625189
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUE LEE
Provider Business Mailing Address
First Line : 19820 SCRIBER LAKE RD STE 2
Second Line :
City : LYNNWOOD
State : WA
Zip : 98036-6121
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 19820 SCRIBER LAKE RD STE 2
Second Line :
City : LYNNWOOD
State : WA
Zip : 98036-6121
Country : US
Telephone Number : 425-780-5297
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2015
Last Update Date : 12/19/2019

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Directions to “ SUE LEE ” Practice Location

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