Individual
LEE M MITSUMORI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
RADIOLOGY UNIVERSITY OF WASHINGTON MEDICAL CTR, 1959 NE PACIFIC ST, SEATTLE, WA 98195-0001
(206) 598-6200
Mailing address
RADIOLOGY UNIVERSITY OF WASHINGTON MEDICAL CTR, 1959 NE PACIFIC STREET, SEATTLE, WA 98195-7115
(206) 598-0024
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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