Provider Demographics
NPI:1669673364
Name:LEE, NANCY J (LMP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:J
Last Name:LEE
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8487
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-0487
Mailing Address - Country:US
Mailing Address - Phone:509-835-4000
Mailing Address - Fax:509-835-4252
Practice Address - Street 1:2702 W SUNSET BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99224-1112
Practice Address - Country:US
Practice Address - Phone:509-835-4000
Practice Address - Fax:509-835-4252
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00005670225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist