Individual
LEE M MITSUMORI
Active
Individual
LEE M MITSUMORI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD00041182
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0231575
L&I
WA
05
—
1972681336
—
WA
01
—
4416
INTERNAL ID-MOTOR VEHICLE ID
—
Enumeration date
11/02/2006
Last updated
04/30/2013
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