| Mr Tae Son Lee, CDP, DVC | |
|
8811 S Tacoma Way #106, Lakewood, WA 98499 | |
| (253) 302-3826 | |
| (253) 946-1660 |
| Full Name | Mr Tae Son Lee |
|---|---|
| Gender | Male |
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 8811 S Tacoma Way #106, Lakewood, Washington |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679904841 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | CP00001153 (Washington) | Primary |
| 101YP2500X | Counselor - Professional | CP00001153 (Washington) | Secondary |
| Entity Name | Asian American Chemical Dependency Treatment Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1144451048 PECOS PAC ID: 2062848104 Enrollment ID: O20200207001351 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Tae Son Lee, CDP, DVC 8811 S Tacoma Way #106, Lakewood, WA 98499 Ph: (253) 302-3826 | Mr Tae Son Lee, CDP, DVC 8811 S Tacoma Way #106, Lakewood, WA 98499 Ph: (253) 302-3826 |
Claudia Hockett, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 9330 59th Ave Sw, Lakewood, WA 98499 Phone: 253-620-5042 | |
Ms. Tammy Marie Stewart, BA Counselor Medicare: Not Enrolled in Medicare Practice Location: 9330 59th Ave Sw, Lakewood, WA 98499 Phone: 253-620-5833 Fax: 253-620-5789 | |
Ms. Sabrina Lavonne Thompson, AAS Counselor Medicare: Not Enrolled in Medicare Practice Location: 9330 59th Ave Sw, Lakewood, WA 98499 Phone: 253-620-5015 Fax: 253-620-5831 | |
Alida Rothgeb, Counselor Medicare: Not Enrolled in Medicare Practice Location: 9330 59th Ave Sw, Lakewood, WA 98499 Phone: 253-620-7020 | |
Ashley Pettis, BS Counselor Medicare: Not Enrolled in Medicare Practice Location: 9330 59th Ave Sw, Lakewood, WA 98499 Phone: 253-620-5015 | |
Tracey Wilber, BA Counselor Medicare: Not Enrolled in Medicare Practice Location: 9330 59th Ave Sw, Lakewood, WA 98499 Phone: 253-620-5015 | |
Christine Leah Daly, Counselor Medicare: Not Enrolled in Medicare Practice Location: 10116 36th Avenue Ct Sw, Lakewood, WA 98499 Phone: 206-999-1153 |