Provider Demographics
NPI:1699183509
Name:LEE, LYNN (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95776-6252
Mailing Address - Country:US
Mailing Address - Phone:530-668-1457
Mailing Address - Fax:530-668-1714
Practice Address - Street 1:1720 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95776-6252
Practice Address - Country:US
Practice Address - Phone:530-668-1457
Practice Address - Fax:530-668-1714
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-24
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56278183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist