Individual
MARTIN MAO-TING LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
702 23RD AVE SE, PUYALLUP, WA 98372-4661
(253) 841-4378
Mailing address
702 23RD AVE SE, PUYALLUP, WA 98372-4661
(253) 841-4378
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD60127504
WA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
5834656-1205
UT
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
MD60127504
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107038443101
IHC
UT
01
—
239024
ALTIUS
UT
01
—
76-00071
UNITED HEALTHCARE
UT
01
—
83555
PEHP
UT
05
—
870281028000
—
UT
01
—
870281028LEE
EMIA
UT
01
—
902460
DMBA
UT
01
—
P00299426
PALMETTO
UT
Enumeration date
07/19/2006
Last updated
04/19/2012
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