Provider Demographics
NPI:1245302967
Name:LEE, NANCY J (L AC)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:J
Last Name:LEE
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:19340 142ND PL SE
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98058-9446
Mailing Address - Country:US
Mailing Address - Phone:206-419-1155
Mailing Address - Fax:
Practice Address - Street 1:1110 EDMONDS AVE NE
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98056-2907
Practice Address - Country:US
Practice Address - Phone:425-255-2226
Practice Address - Fax:425-235-0118
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00002342171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist