Individual
MR. MIKE I LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PY
Contact information
Practice address
720 8TH AVE S, SUITE 100, SEATTLE, WA 98104-3032
(206) 788-3718
Mailing address
PO BOX 24911, SEATTLE, WA 98124-0911
(206) 788-3683
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY00003129
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5762LE
REGENCE
—
01
—
6921LE
REGENCE
—
05
—
8492977
—
WA
Enumeration date
08/28/2006
Last updated
10/29/2007
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