Provider Demographics
NPI:1720204324
Name:LEE, JAIME JUNE YOUNG (DDS)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:JUNE YOUNG
Last Name:LEE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 BOREN AVE
Mailing Address - Street 2:SUITE 1030
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104
Mailing Address - Country:US
Mailing Address - Phone:206-325-7200
Mailing Address - Fax:206-623-3117
Practice Address - Street 1:1001 BROADWAY
Practice Address - Street 2:SUITE 317
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-4397
Practice Address - Country:US
Practice Address - Phone:206-325-7200
Practice Address - Fax:206-322-1791
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2017-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE94241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice