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Individual

MICAH LEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
11311 BRIDGEPORT WAY SW STE 100, LAKEWOOD, WA 98499-3096
(253) 985-2949
(253) 985-2948
Mailing address
11311 BRIDGEPORT WAY SW STE 100, LAKEWOOD, WA 98499-3096
(253) 985-2949
(253) 985-2948

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
C5-0011606
DE
363A00000X
Physician Assistant
Primary
PA61413217
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2254732
WA
Enumeration date
12/22/2020
Last updated
10/14/2025
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