Provider Demographics
NPI:1871260042
Name:LEE, TAMMY (MA, LPC-ASSOCIATE)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:MA, LPC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14410 77TH AVENUE CT E
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98375-7048
Mailing Address - Country:US
Mailing Address - Phone:541-671-2777
Mailing Address - Fax:
Practice Address - Street 1:777 HIGH ST STE 240
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2759
Practice Address - Country:US
Practice Address - Phone:541-357-3248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-25
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR6977101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORHM301E9JMedicaid