Provider Demographics
NPI:1811213978
Name:LEE, JULIE (LACMACOM)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:LACMACOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4577 NW CORAZON TER
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97229-9395
Mailing Address - Country:US
Mailing Address - Phone:503-475-2577
Mailing Address - Fax:
Practice Address - Street 1:12655 SW CENTER ST STE 140
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-1600
Practice Address - Country:US
Practice Address - Phone:503-756-2743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-14
Last Update Date:2025-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC150767171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist