Provider Demographics
NPI:1871823856
Name:LEE, HEUNG (LAC)
Entity Type:Individual
Prefix:
First Name:HEUNG
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5001 SOMERSET DR SE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-3429
Mailing Address - Country:US
Mailing Address - Phone:425-761-4820
Mailing Address - Fax:
Practice Address - Street 1:12727 NE 20TH ST
Practice Address - Street 2:SUITE 14
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-1917
Practice Address - Country:US
Practice Address - Phone:425-881-0968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-13
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60115270171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist