Provider Demographics
NPI:1821104316
Name:KILBURN, H. LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:H. LEE
Middle Name:
Last Name:KILBURN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:HOWARD
Other - Middle Name:LEE
Other - Last Name:KILBURN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:207 8TH AVE W
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-5319
Mailing Address - Country:US
Mailing Address - Phone:425-822-4119
Mailing Address - Fax:
Practice Address - Street 1:207 8TH AVE W
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-5319
Practice Address - Country:US
Practice Address - Phone:425-822-4119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1460401Medicaid
WA1460401Medicaid