Individual
DR. KEN P LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2740 PACIFIC AVE SE, OLYMPIA, WA 98501-2037
(360) 705-3061
Mailing address
2740 PACIFIC AVE SE, OLYMPIA, WA 98501-2037
(360) 705-3061
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD34440
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0113105
LABOR & INDUSTRIES
WA
01
—
LE4906
REGENCE BLUESHIELD
WA
01
—
P00650748
RR MEDICARE PALMETTO GBA
WA
Enumeration date
11/27/2007
Last updated
03/03/2012
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