Provider Demographics
NPI:1386788784
Name:LEE, ANGIE K (MD)
Entity type:Individual
Prefix:
First Name:ANGIE
Middle Name:K
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1115 SE 164TH AVE
Mailing Address - Street 2:DEPT 364
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-9324
Mailing Address - Country:US
Mailing Address - Phone:360-715-4186
Mailing Address - Fax:360-715-4187
Practice Address - Street 1:3015 SQUALICUM PKWY
Practice Address - Street 2:STE 100
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1945
Practice Address - Country:US
Practice Address - Phone:360-715-4186
Practice Address - Fax:360-715-4187
Is Sole Proprietor?:No
Enumeration Date:2007-02-18
Last Update Date:2021-11-13
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Provider Licenses
StateLicense IDTaxonomies
WAMD60061916207RG0300X, 207RH0002X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine