Provider Demographics
NPI:1386817575
Name:KAREN LEE, A.R.N.P., INC
Entity Type:Organization
Organization Name:KAREN LEE, A.R.N.P., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:360-424-2112
Mailing Address - Street 1:1725 S 10TH ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98274-5029
Mailing Address - Country:US
Mailing Address - Phone:360-424-2112
Mailing Address - Fax:360-424-2132
Practice Address - Street 1:1725 S 10TH ST
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98274-5029
Practice Address - Country:US
Practice Address - Phone:360-424-2112
Practice Address - Fax:360-424-2132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2017-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30000477261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9600701Medicaid
WAR12735Medicare UPIN
WA9600701Medicaid