Provider Demographics
NPI:1770640161
Name:AMSLER, LEE C (MD)
Entity type:Individual
Prefix:
First Name:LEE
Middle Name:C
Last Name:AMSLER
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:PO BOX 34581
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-1581
Mailing Address - Country:US
Mailing Address - Phone:206-326-3020
Mailing Address - Fax:206-326-3659
Practice Address - Street 1:125 16TH AVE E
Practice Address - Street 2:GROUP HEALTH COOPERATIVE, CARDIOLOGY
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-5211
Practice Address - Country:US
Practice Address - Phone:206-326-3020
Practice Address - Fax:206-326-3659
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00018591207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8560302Medicaid
WAE86871Medicare UPIN
WA060060477Medicare PIN
WAG8880285Medicare PIN
WA8560302Medicaid