Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | MD00045831 | WA |
NPI | 1043294655 |
---|---|
Provider Name | Samson Lee |
First Address | Seattle, WA 98104-1172 |
Second Address | Bellevue, WA 98004-3804 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2005 |
Last Update Date | 23/10/2014 |