Provider Demographics
NPI:1255485660
Name:LEE, HOWARD M (LAC)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:M
Last Name:LEE
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1626 N ATLANTIC ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-4801
Mailing Address - Country:US
Mailing Address - Phone:509-484-5661
Mailing Address - Fax:509-484-5668
Practice Address - Street 1:2216 W AIMEE CT
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-9285
Practice Address - Country:US
Practice Address - Phone:509-467-4576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA154171100000X
IDACU8171100000X
MT116171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist