Provider Demographics
NPI:1588737944
Name:BARNHART, LEE EDWARD (OD)
Entity type:Individual
Prefix:
First Name:LEE
Middle Name:EDWARD
Last Name:BARNHART
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1288
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98041-1288
Mailing Address - Country:US
Mailing Address - Phone:425-485-5101
Mailing Address - Fax:425-485-2908
Practice Address - Street 1:10614 BEARDSSLEE BLVD
Practice Address - Street 2:#A
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-3296
Practice Address - Country:US
Practice Address - Phone:425-485-5101
Practice Address - Fax:425-485-2908
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA993TX152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2013209Medicaid
WA2013209Medicaid