Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | MD00018835 | WA |
NPI | 1497845770 |
---|---|
Provider Name | Roger B Lee |
First Address | Tacoma, WA 98405-4250 |
Second Address | Tacoma, WA 98405-4250 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1088434 | (05) | WA |
A08970 | (02) | WA |