Basic Information
Provider Information
NPI: 1356519789
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LEE
FirstName: LYNDA
MiddleName: L.
NamePrefix:  
NameSuffix:  
Credential: ARNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2600 SW HOLDEN ST
Address2: NAVOS
City: SEATTLE
State: WA
PostalCode: 98126
CountryCode: US
TelephoneNumber: 2069337000
FaxNumber: 2069334064
Practice Location
Address1: 1210 SW 136TH ST
Address2: NAVOS - MENTAL HEALTH AND WELLNESS CENTER
City: BURIEN
State: WA
PostalCode: 98166
CountryCode: US
TelephoneNumber: 2062576601
FaxNumber: 2062576827
Other Information
ProviderEnumerationDate: 02/19/2008
LastUpdateDate: 12/02/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000XRN00084376WAN Nursing Service ProvidersRegistered Nurse 
363LP0808XAP60518692WAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsych/Mental Health

No ID Information.


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