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
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN00084376 | WA | N |   | Nursing Service Providers | Registered Nurse |   | 363LP0808X | AP60518692 | WA | Y |   | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.