Organization
BASIN FOOT & ANKLE PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL LEE DPM (OWNER)
(509) 765-4431
Entity
Organization
Contact information
Practice address
1336 S PIONEER WAY, STE 101, MOSES LAKE, WA 98837-4622
(509) 765-4431
(509) 765-4103
Mailing address
1336 S PIONEER WAY, SUITE 101, MOSES LAKE, WA 98837-4622
(509) 765-4431
(509) 765-4103
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO00000699
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0150382
L & I
WA
05
—
7105216
—
WA
01
—
9050626
MEDICAID PROSTHETIC #
WA
Enumeration date
04/19/2006
Last updated
10/24/2007
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