Provider Demographics
NPI:1275526964
Name:LEE A SANDERS MD INC PS
Entity Type:Organization
Organization Name:LEE A SANDERS MD INC PS
Other - Org Name:HIGHLINE PATHOLOGY ASSOCIATES PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GARRETT
Authorized Official - Middle Name:D
Authorized Official - Last Name:ALCORN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:206-592-5000
Mailing Address - Street 1:16251 SYLVESTER RD SW
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-3017
Mailing Address - Country:US
Mailing Address - Phone:206-592-5000
Mailing Address - Fax:
Practice Address - Street 1:16251 SYLVESTER RD SW
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-3017
Practice Address - Country:US
Practice Address - Phone:206-439-5462
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA207ZP0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WACG0302OtherRR MEDICARE
WA7097777Medicaid
WA7097777Medicaid