Individual
JUAN MIGUEL LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
931 S MARKET BLVD, PMG SW WA CHEHALIS FAMILY MEDICINE, CHEHALIS, WA 98532-3423
(360) 767-6300
Mailing address
PO BOX 3360, PORTLAND, OR 97208-3360
(866) 747-2455
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
237030
MA
207Q00000X
Family Medicine Physician
Primary
MD60463053
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD60463053
WA STATE LICENSE
WA
Enumeration date
01/06/2010
Last updated
05/20/2021
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