Provider Demographics
NPI:1740486232
Name:LEE, JUSTIN (DC)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8815 S TACOMA WAY STE 120
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-7011
Mailing Address - Country:US
Mailing Address - Phone:253-202-3377
Mailing Address - Fax:253-682-2841
Practice Address - Street 1:18904 HIGHWAY 99 STE Q
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-5219
Practice Address - Country:US
Practice Address - Phone:253-202-3377
Practice Address - Fax:253-682-2841
Is Sole Proprietor?:No
Enumeration Date:2007-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034178111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor