MEDICARE: MS. JENNIFER LEE MSW

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
1	1041C0700X	Clinical Social Worker	LW00007904	WA

General Provider Information

NPI Number	:	1801966379
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JENNIFER LEE MSW

Provider Business Mailing Address
First Line	:	2027 196TH ST SW STE A205
Second Line	:
City	:	LYNNWOOD
State	:	WA
Zip	:	98036-7073
Country	:	US
Telephone Number	:	206-558-4488
Fax Number	:

Provider Business Practice Location Address
First Line	:	2027 196TH ST SW STE A205
Second Line	:
City	:	LYNNWOOD
State	:	WA
Zip	:	98036-7073
Country	:	US
Telephone Number	:	206-558-4488
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/09/2006
Last Update Date	:	12/05/2024

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