Provider Demographics
NPI:1427342153
Name:LEE, CLARA S (MSW)
Entity type:Individual
Prefix:MS
First Name:CLARA
Middle Name:S
Last Name:LEE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:CLARE
Other - Middle Name:S
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW
Mailing Address - Street 1:17220 127TH PL NE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-7965
Mailing Address - Country:US
Mailing Address - Phone:425-890-3553
Mailing Address - Fax:
Practice Address - Street 1:17220 127TH PL NE
Practice Address - Street 2:SUITE 102
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-7965
Practice Address - Country:US
Practice Address - Phone:425-890-3553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-28
Last Update Date:2011-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA#LW601303841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical