Provider Demographics
NPI:1336646066
Name:LEE, DANIEL JUNHO (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:JUNHO
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 1:21911 76TH AVE W STE 211
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-7918
Mailing Address - Country:US
Mailing Address - Phone:425-775-6651
Mailing Address - Fax:425-670-6718
Practice Address - Street 1:21911 76TH AVE W STE 211
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-7918
Practice Address - Country:US
Practice Address - Phone:425-775-6651
Practice Address - Fax:425-670-6718
Is Sole Proprietor?:No
Enumeration Date:2018-04-09
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD61421136207Y00000X, 207YX0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2253029Medicaid