Provider Demographics
NPI:1821284753
Name:LEE, JONATHAN CHUANG-YIEN (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:CHUANG-YIEN
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5477 MOORETOWN RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-2108
Mailing Address - Country:US
Mailing Address - Phone:757-565-0106
Mailing Address - Fax:
Practice Address - Street 1:5477 MOORETOWN RD
Practice Address - Street 2:FARLEY CENTER AT WILLIAMSBURG PLACE
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-2108
Practice Address - Country:US
Practice Address - Phone:757-565-0106
Practice Address - Fax:757-565-0620
Is Sole Proprietor?:No
Enumeration Date:2007-09-25
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101247972207RA0401X, 2084A0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine