Provider Demographics
NPI:1467765636
Name:CHONG-MCBRIDE, LEE LI
Entity Type:Individual
Prefix:
First Name:LEE LI
Middle Name:
Last Name:CHONG-MCBRIDE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 S UNION AVE # 102
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-1959
Mailing Address - Country:US
Mailing Address - Phone:253-759-3555
Mailing Address - Fax:253-759-2988
Practice Address - Street 1:1311 S UNION AVE # 102
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-1959
Practice Address - Country:US
Practice Address - Phone:253-759-3555
Practice Address - Fax:253-759-2988
Is Sole Proprietor?:No
Enumeration Date:2010-07-16
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAHA00004637237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist