Provider Demographics
NPI:1194025684
Name:LEE, ALBERT (PHARMD)
Entity type:Individual
Prefix:
First Name:ALBERT
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19133 WILLAMETTE DR
Mailing Address - Street 2:
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-2019
Mailing Address - Country:US
Mailing Address - Phone:503-303-1099
Mailing Address - Fax:503-303-1095
Practice Address - Street 1:19133 WILLAMETTE DR
Practice Address - Street 2:
Practice Address - City:WEST LINN
Practice Address - State:OR
Practice Address - Zip Code:97068-2019
Practice Address - Country:US
Practice Address - Phone:503-303-1099
Practice Address - Fax:503-303-1095
Is Sole Proprietor?:No
Enumeration Date:2010-10-29
Last Update Date:2014-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR12458183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist