Provider Demographics
NPI:1043826977
Name:LEE, HALEEMA H
Entity type:Individual
Prefix:
First Name:HALEEMA
Middle Name:H
Last Name:LEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HALEEMA
Other - Middle Name:
Other - Last Name:HAMEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8747 WALLINGFORD LN NE
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98516-5803
Mailing Address - Country:US
Mailing Address - Phone:253-359-5796
Mailing Address - Fax:
Practice Address - Street 1:8747 WALLINGFORD LN NE
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98516-5803
Practice Address - Country:US
Practice Address - Phone:253-359-5796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-16
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASA2367171R00000X
WAMA4530171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter