Individual
KYOUNG MI LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4220 WHEATON WAY, BREMERTON, WA 98310-3604
(253) 509-8810
Mailing address
4220 WHEATON WAY, BREMERTON, WA 98310-3604
(253) 509-8810
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
26023085A
IN
183500000X
Pharmacist
Primary
PH60077511
WA
183500000X
Pharmacist
RPH03329197
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W178911739
AETNA
WA
Enumeration date
07/01/2010
Last updated
07/01/2010
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