Provider Information for 1659980506
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PATRICIA LEE
Sex: Female
NPI: 1659980506
Last Updated: 2022-05-12
Certification Date: 2022-05-12
Certification Date: 2022-05-12
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1659980506 | ||||||||
| Enumeration Date | 2020-07-27 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 6124 SE MILWAUKIE AVE PORTLAND, OR 97202-5347 United States Phone: 503-997-6033 | Fax: | ||||||||
| Primary Practice Address | 6124 SE MILWAUKIE AVE PORTLAND, OR 97202-5347 United States Phone: 503-997-6033 | Fax: | ||||||||
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