Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RI0200X | Infectious Disease | 12215 | NH |
Y | 207RI0200X | Infectious Disease | MD60629058 | WA |
NPI | 1023071370 |
---|---|
Provider Name | Kristin M Lee |
First Address | Bremerton, WA 98310-4215 |
Second Address | Bremerton, WA 98310-4215 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2006 |
Last Update Date | 07/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2072682 | (05) | WA |
30204384 | (05) | NH |
3075203 | (05) | NH |
H35525 | (02) |