Individual
JIYEON LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16108 ASH WAY STE 202, LYNNWOOD, WA 98087-8781
(201) 871-3555
Mailing address
370 GRAND AVE STE 200, ENGLEWOOD, NJ 07631-4109
(201) 871-3555
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
61313136
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1588311856
NPI
WA
Enumeration date
03/07/2022
Last updated
03/12/2024
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