Provider Demographics
NPI:1922101500
Name:LEE, YOUNG H (MD)
Entity Type:Individual
Prefix:DR
First Name:YOUNG
Middle Name:H
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 1:33507 9TH AVE S
Mailing Address - Street 2:BLDG. #A
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6397
Mailing Address - Country:US
Mailing Address - Phone:253-874-5404
Mailing Address - Fax:253-874-8964
Practice Address - Street 1:33507 9TH AVE S
Practice Address - Street 2:BLDG.#A
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6397
Practice Address - Country:US
Practice Address - Phone:253-874-5404
Practice Address - Fax:253-874-8964
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00029607207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1033556OtherPROVIDERONE
WA1114743Medicaid
0155621OtherLABOR AND INDUSTRIES
0155621OtherLABOR AND INDUSTRIES
WA1033556OtherPROVIDERONE