Provider Demographics
NPI:1902796105
Name:LEE, DANIELLE KAY (RN-BSN)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:KAY
Last Name:LEE
Suffix:
Gender:F
Credentials:RN-BSN
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 305
Mailing Address - Street 2:
Mailing Address - City:CLEARLAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98235-0305
Mailing Address - Country:US
Mailing Address - Phone:360-421-4467
Mailing Address - Fax:
Practice Address - Street 1:301 VALLEY MALL WAY STE 110
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-5462
Practice Address - Country:US
Practice Address - Phone:360-416-1568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61044725163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse