Provider Demographics
NPI:1962577312
Name:LEE, META T (MD)
Entity type:Individual
Prefix:DR
First Name:META
Middle Name:T
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4011 TALBOT RD S
Mailing Address - Street 2:SUITE 220
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-5773
Mailing Address - Country:US
Mailing Address - Phone:425-785-9935
Mailing Address - Fax:425-656-5402
Practice Address - Street 1:4011 TALBOT RD S
Practice Address - Street 2:SUITE 220
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-5773
Practice Address - Country:US
Practice Address - Phone:425-785-9935
Practice Address - Fax:425-656-5402
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-9858208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIG9858Medicare UPIN