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Organization
LEE PRACTICE II
Active
Organization
LEE PRACTICE II
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JIYOUNG LEE DMD (PRESIDENT)
(503) 953-0000
Entity
Organization
Contact information
Practice address
1401 SE MORRISON ST, STE 120, PORTLAND, OR 97214
(503) 953-0000
Mailing address
2150 NE DIVISION ST, STE 201, GRESHAM, OR 97030
(503) 953-0000
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D8776
OR
Other
Enumeration date
11/21/2014
Last updated
11/21/2014
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