Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 9539 | WA |
Y | 213EG0000X | General Practice | 9539 | WA |
NPI | 1003899832 |
---|---|
Provider Name | Dr. Stephen J Lee |
First Address | Everett, WA 98208-5100 |
Second Address | Everett, WA 98208-5100 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/11/2005 |
Last Update Date | 08/07/2007 |