Provider Demographics
NPI:1689900524
Name:LEE CLINIC TR
Entity Type:Organization
Organization Name:LEE CLINIC TR
Other - Org Name:MICHAEL LEE, MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:SCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-368-1700
Mailing Address - Street 1:1530 N 115TH ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-8421
Mailing Address - Country:US
Mailing Address - Phone:206-368-1311
Mailing Address - Fax:
Practice Address - Street 1:1530 N 115TH ST
Practice Address - Street 2:SUITE 104
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-8421
Practice Address - Country:US
Practice Address - Phone:206-368-1311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-28
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty