Provider Demographics
NPI:1013210418
Name:LEE, JEENA S (RPH)
Entity Type:Individual
Prefix:MS
First Name:JEENA
Middle Name:S
Last Name:LEE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8704 GREENWOOD AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-3616
Mailing Address - Country:US
Mailing Address - Phone:206-494-0440
Mailing Address - Fax:206-494-0437
Practice Address - Street 1:8704 GREENWOOD AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-3616
Practice Address - Country:US
Practice Address - Phone:206-494-0440
Practice Address - Fax:206-494-0437
Is Sole Proprietor?:No
Enumeration Date:2010-12-08
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH 00022434183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist