Jonathan Lee, MD | |
1205 Se Professional Mall Blvd Ste 104, Pullman, WA 99163-5423 | |
(509) 332-2605 | |
Not Available |
Full Name | Jonathan Lee |
---|---|
Gender | Male |
Speciality | Pediatrics |
Location | 1205 Se Professional Mall Blvd Ste 104, Pullman, Washington |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1679935530 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | ML60657369 (Washington) | Secondary |
208000000X | Pediatrics | MD60947065 (Washington) | Primary |
Entity Name | Public Hospital District #1-a Of Whitman County |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1366446767 PECOS PAC ID: 8325934987 Enrollment ID: O20040223000506 |
Entity Name | Pullman Regional Hospital Clinic Network Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1710218839 PECOS PAC ID: 4183753247 Enrollment ID: O20100527000556 |
Mailing Address | Practice Location Address |
---|---|
Jonathan Lee, MD 1205 Se Professional Mall Blvd Ste 104, Pullman, WA 99163-5423 Ph: (509) 332-2605 | Jonathan Lee, MD 1205 Se Professional Mall Blvd Ste 104, Pullman, WA 99163-5423 Ph: (509) 332-2605 |
Martha Hunt, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: Ne 1125 Washington St, Washington State University, Pullman, WA 99164 Phone: 509-335-3575 | |
Joseph O Aiyenowo, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 825 Se Bishop Blvd Ste 200, Pullman, WA 99163 Phone: 509-332-2517 Fax: 509-334-9247 | |
Michael J Frostad, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1205 Se Professional Mall Blvd, Suite104, Pullman, WA 99163 Phone: 509-332-2605 Fax: 509-334-5754 | |
Lennis K Boyer, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1205 Se Professional Mall Blvd, Suite 104, Pullman, WA 99163 Phone: 509-332-2605 Fax: 509-334-5754 | |
Mackenzie Claire Rinaldi, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 1205 Se Professional Mall Blvd Ste 104, Pullman, WA 99163 Phone: 509-332-2605 Fax: 509-715-2123 | |
Maricarmen Stout Shields, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1205 Se Professional Mall Blvd Ste 104, Pullman, WA 99163 Phone: 509-332-2605 Fax: 509-334-5754 |