Individual
GAVIN LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
23605 NE 108TH ST, VANCOUVER, WA 98682-9549
(415) 915-4626
Mailing address
23605 NE 108TH ST, VANCOUVER, WA 98682-9549
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
60473560
WA
225100000X
Physical Therapist
Primary
60815
OR
Other
Enumeration date
03/17/2020
Last updated
03/17/2020
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