Provider Demographics
NPI:1902830367
Name:ANG-LEE, MICHAEL K
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:K
Last Name:ANG-LEE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1229 MADISON ST STE 1440
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-3538
Mailing Address - Country:US
Mailing Address - Phone:206-625-0578
Mailing Address - Fax:206-625-9184
Practice Address - Street 1:1229 MADISON ST STE 1440
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3538
Practice Address - Country:US
Practice Address - Phone:206-625-0578
Practice Address - Fax:206-625-9184
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00041361207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
3169ANOtherBS REGENCE
WA8316960Medicaid
189624OtherL&I
WA8316960Medicaid
3169ANOtherBS REGENCE
WAH55100Medicare UPIN