Provider Demographics
NPI:1871031864
Name:LEE, ABREY (RD)
Entity Type:Individual
Prefix:MRS
First Name:ABREY
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4011 TALBOT RD S
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-5773
Mailing Address - Country:US
Mailing Address - Phone:425-656-4006
Mailing Address - Fax:
Practice Address - Street 1:4011 TALBOT RD S
Practice Address - Street 2:SUITE 100
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-5773
Practice Address - Country:US
Practice Address - Phone:425-656-4006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-09
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1089137133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered