1275944928 NPI number — MRS. ROBIN JILL LEE MA, LMHC,MHP

Table of content: MRS. ROBIN JILL LEE MA, LMHC,MHP (NPI 1275944928)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275944928 NPI number — MRS. ROBIN JILL LEE MA, LMHC,MHP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LEE
Provider First Name:
ROBIN
Provider Middle Name:
JILL
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MA, LMHC,MHP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ADLER
Provider Other First Name:
ROBIN
Provider Other Middle Name:
JILL
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MA, LMHC,MHP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1275944928
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/08/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
304 SE HEARTWOOD BLVD
Provider Second Line Business Mailing Address:
UNIT 873932
Provider Business Mailing Address City Name:
VANCOUVER
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98687
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-861-4724
Provider Business Mailing Address Fax Number:
360-397-8494

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
304 SE HEARTWOOD BLVD
Provider Second Line Business Practice Location Address:
UNIT 873932
Provider Business Practice Location Address City Name:
VANCOUVER
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98687
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-861-4724
Provider Business Practice Location Address Fax Number:
360-397-8494
Provider Enumeration Date:
05/15/2014

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  CG60475236 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X , with the licence number: LH60607283 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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