Provider Demographics
NPI:1326230079
Name:LE, WILLIAM LEE
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:LEE
Last Name:LE
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 1:10010 NE 75TH ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-3808
Mailing Address - Country:US
Mailing Address - Phone:360-624-6058
Mailing Address - Fax:
Practice Address - Street 1:6202 NE HIGHWAY 99 STE 8
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-8747
Practice Address - Country:US
Practice Address - Phone:360-695-6065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-16
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00024420174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist