Individual
KELLIE BIANCA LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
1421 WESTERN AVE, SEATTLE, WA 98101-2021
(206) 624-3590
(206) 583-4139
Mailing address
1421 WESTERN AVE, SEATTLE, WA 98101-2021
(206) 624-3590
(206) 583-4139
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA 60060129
WA
Other
Enumeration date
02/10/2009
Last updated
05/20/2009
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