Provider Demographics
NPI:1043266810
Name:LEE, CHRISTOPHER MELVIN (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:MELVIN
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3868
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99220-3868
Mailing Address - Country:US
Mailing Address - Phone:509-228-1000
Mailing Address - Fax:509-252-9300
Practice Address - Street 1:1204 N VERCLER RD
Practice Address - Street 2:STE201
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-1020
Practice Address - Country:US
Practice Address - Phone:509-228-1000
Practice Address - Fax:509-252-9300
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000462232085R0001X
IDM-121582085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID807438900Medicaid
7339812OtherAETNA
WA7676LEOtherAETNA
P00326349OtherRAILROAD MEDICARE
WA0208095OtherLABOR & INDUSTRIES
IDKAU76OtherBLUE CROSS OF IDAHO
ID000010157196OtherBLUE SHIELD OF IDAHO
WA8500423Medicaid
WA8500423Medicaid
ID20006125Medicare PIN
WA0208095OtherLABOR & INDUSTRIES