Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 252633 | NY |
Y | 2080P0210X | Pediatric Nephrologist | MD157615 | OR |
NPI | 1306077847 |
---|---|
Provider Name | Joyce J Lee |
First Address | Portland, OR 97227-1654 |
Second Address | Portland, OR 97227-1654 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2009 |
Last Update Date | 17/10/2014 |