Provider Demographics
NPI:1801838891
Name:LEE, UYEN TRUONG (MD)
Entity Type:Individual
Prefix:
First Name:UYEN
Middle Name:TRUONG
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9621 RIDGETOP BLVD NW
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-8502
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1780 NW MYHRE RD
Practice Address - Street 2:SUITE 2120
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-8676
Practice Address - Country:US
Practice Address - Phone:360-782-3100
Practice Address - Fax:360-782-3141
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00034798208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8936963OtherCRIME VICTIMS COMP
5121509OtherAETNA
WA113754OtherLABOR & INDUSTRIES
WA8207458Medicaid
370009257OtherRAILROAD MEDICARE
1177LEOtherREGENCE BLUESHIELD
1177LEOtherREGENCE BLUESHIELD
WAGAB01368Medicare PIN
WAGAB01366Medicare PIN
G49932Medicare UPIN
WAGAB01369Medicare PIN
WAGAB10370Medicare PIN
BL5391074OtherDEA
WA8207458Medicaid