Individual
JAEYEON LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 S PIONEER WAY, MOSES LAKE, WA 98837-1812
(509) 765-1219
Mailing address
601 S DIVISION ST APT 6, MOSES LAKE, WA 98837-3822
(206) 909-0534
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH61565986
WA
Other
Enumeration date
01/13/2025
Last updated
01/13/2025
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