Provider Demographics
NPI:1225924038
Name:LEE, YOUNG C
Entity type:Individual
Prefix:
First Name:YOUNG
Middle Name:C
Last Name:LEE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 BELLEVUE WAY SE APT 202
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-6201
Mailing Address - Country:US
Mailing Address - Phone:253-222-0068
Mailing Address - Fax:
Practice Address - Street 1:11418 NE 19TH ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3030
Practice Address - Country:US
Practice Address - Phone:253-222-0068
Practice Address - Fax:253-222-0068
Is Sole Proprietor?:No
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60592240225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist