Ken P Lee Md Pllc | |
2740 Pacific Ave Se Olympia WA 98501 | |
(360) 705-3061 | |
(360) 705-2965 |
Full Name | Ken P Lee Md Pllc |
---|---|
Speciality | Internal Medicine |
Location | 2740 Pacific Ave Se, Olympia, Washington |
Authorized Official Name and Position | Ken P Lee (MEMBER PRESIDENT) |
Authorized Official Contact | 3607053061 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Ken P Lee Md Pllc Po Box 11009 Olympia WA 98508-1009 Ph: (360) 352-2037 | Ken P Lee Md Pllc 2740 Pacific Ave Se Olympia WA 98501 Ph: (360) 705-3061 |
NPI Number | 1689778979 |
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Provider Enumeration Date | 09/08/2006 |
Last Update Date | 03/30/2011 |
Medicare PECOS PAC ID | 7911991260 |
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Medicare Enrollment ID | O20040412000328 |
Identifier | Type | State | Issuer |
---|---|---|---|
1689778979 | NPI | - | NPPES |
1100098 | Medicaid | WA | |
DN9936 | Other | WA | RR MEDICARE PALMETTO GBA |
0113105 | Other | WA | LABOR & INDUSTRIES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | MD34440 (Washington) | Primary |
Provider Name | Ken P Lee |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1740462233 PECOS PAC ID: 5890789143 Enrollment ID: I20101119000047 |
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