Individual
DR. LEE P THELEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
33801 1ST WAY S, #361, FEDERAL WAY, WA 98003-4546
(253) 838-4200
(253) 838-4014
Mailing address
5221 ORCA DR NE, TACOMA, WA 98422-1945
(253) 927-8843
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6184
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
654977
UNITED CONCORDIA
WA
01
—
TH2653
REGENCE BLUE SHIELD
WA
Enumeration date
08/20/2006
Last updated
07/08/2007
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