Individual
MAMIE LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3565 HALIEGH PL, LONGVIEW, WA 98632-4778
(369) 430-7436
Mailing address
3565 HALIEGH PL, LONGVIEW, WA 98632-4778
(369) 430-7435
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH00005237
WA
124Q00000X
Dental Hygienist
H3962
OR
Other
Enumeration date
03/10/2014
Last updated
03/10/2014
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