Provider Demographics
NPI:1144654237
Name:LEE, SHARON J (LCPO)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:J
Last Name:LEE
Suffix:
Gender:F
Credentials:LCPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 12TH AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-5599
Mailing Address - Country:US
Mailing Address - Phone:206-328-4276
Mailing Address - Fax:206-328-1037
Practice Address - Street 1:411 12TH AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-5599
Practice Address - Country:US
Practice Address - Phone:206-328-4276
Practice Address - Fax:206-328-1037
Is Sole Proprietor?:No
Enumeration Date:2013-08-26
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9015561Medicaid
WA9015561Medicaid