Provider Demographics
NPI:1538948625
Name:LEE, ELLE MARIE (ND)
Entity type:Individual
Prefix:DR
First Name:ELLE
Middle Name:MARIE
Last Name:LEE
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23515 NE NOVELTY HILL RD STE B221
Mailing Address - Street 2:#174
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98053-1996
Mailing Address - Country:US
Mailing Address - Phone:360-631-6329
Mailing Address - Fax:
Practice Address - Street 1:22635 NE MARKETPLACE DR STE 130
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98053-5886
Practice Address - Country:US
Practice Address - Phone:425-949-5961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61470994175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath