Provider Demographics
NPI:1831392208
Name:LEE, WAISAN WENDY (MS, LMFTA)
Entity type:Individual
Prefix:MS
First Name:WAISAN
Middle Name:WENDY
Last Name:LEE
Suffix:
Gender:F
Credentials:MS, LMFTA
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:WAISAN
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1740 NW MAPLE STREET
Mailing Address - Street 2:SUITE 210
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027
Mailing Address - Country:US
Mailing Address - Phone:425-427-2474
Mailing Address - Fax:425-458-4675
Practice Address - Street 1:1740 NW MAPLE STREET
Practice Address - Street 2:SUITE 210
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027
Practice Address - Country:US
Practice Address - Phone:425-427-2474
Practice Address - Fax:425-458-4675
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00045794106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist