Basic Information
| Provider Information | |||||||||
| NPI: | 1386040616 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | YEE | ||||||||
| FirstName: | JIMMY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1115 SE 164TH AVE DEPT 358 | ||||||||
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| City: | VANCOUVER | ||||||||
| State: | WA | ||||||||
| PostalCode: | 986838004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3607291462 | ||||||||
| FaxNumber: | 3607291462 | ||||||||
| Practice Location | |||||||||
| Address1: | PEACEHEALTH MEDICAL GROUP | ||||||||
| Address2: | 2979 SQUALICUM PARKWAY, SUITE 101 | ||||||||
| City: | BELLINGHAM | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98225 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3607342700 | ||||||||
| FaxNumber: | 3607348362 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/13/2014 | ||||||||
| LastUpdateDate: | 07/24/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 9516 | SD | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | MD60922630 | WA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0000X | MD60922630 | WA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RI0011X | MD60922630 | WA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology |
No ID Information.