Individual
BONITA BEN LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1100 9TH AVE, SEATTLE, WA 98101-2756
(206) 223-7530
Mailing address
1100 9TH AVE, SEATTLE, WA 98101-2756
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
51766
CA
363A00000X
Physician Assistant
Primary
PA60805768
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G8975942
—
WA
05
—
G8975943
—
WA
05
—
G8975944
—
WA
Enumeration date
12/03/2014
Last updated
11/30/2020
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