Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 2300 | TX |
NPI | 1083029995 |
---|---|
Provider Name | Dr. Edward Lee |
First Address | Auburn, WA 98002-5015 |
Second Address | Auburn, WA 98002-5015 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2014 |
Last Update Date | 23/09/2021 |