Provider Demographics
NPI:1609236660
Name:YEE, LISA (PT)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:YEE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5252 LYNGATE CT
Mailing Address - Street 2:STE 203
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-1672
Mailing Address - Country:US
Mailing Address - Phone:703-239-2300
Mailing Address - Fax:703-239-2301
Practice Address - Street 1:3 WASHINGTON CIR NW
Practice Address - Street 2:STE 110
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-2356
Practice Address - Country:US
Practice Address - Phone:202-659-7625
Practice Address - Fax:202-659-7740
Is Sole Proprietor?:No
Enumeration Date:2016-03-03
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPT871938225100000X
MD25859225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist