Individual
MR. SANG LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
21601 76TH AVE W, EDMONDS, WA 98026-7507
(630) 215-9892
Mailing address
21601 76TH AVE W, EDMONDS, WA 98026-7507
(630) 215-9892
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
60280503
WA
363LA2100X
Acute Care Nurse Practitioner
209.006502
IL
Other
Enumeration date
05/02/2011
Last updated
04/09/2012
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