Provider Demographics
NPI:1184693863
Name:LEE, WON Y (RPH)
Entity type:Individual
Prefix:MR
First Name:WON
Middle Name:Y
Last Name:LEE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5513 WILSON BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-1119
Mailing Address - Country:US
Mailing Address - Phone:703-525-0200
Mailing Address - Fax:703-525-0502
Practice Address - Street 1:5513 WILSON BLVD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-1119
Practice Address - Country:US
Practice Address - Phone:703-525-0200
Practice Address - Fax:703-525-0502
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202009287183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist