Bourdeau, Lee Mason
Bourdeau, Lee Mason is an individual health care provider with primary practice located at 7440 Pacific Ave , Tacoma WA 98408-7117. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / General Practice, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Bourdeau, Lee Mason can be contacted via phone (253) 475-0511.Contact Information
Primary practice address
7440 Pacific Ave
Tacoma WA 98408-7117
Phone: (253) 475-0511
Fax: (253) 475-7440
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | MD00013784 | Washington |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | MD00013784 | Washington |
Profile Details
| NPI number | 1467483628 |
|---|---|
| LBN Legal business name | Bourdeau, Lee Mason |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 6th, 2006 |
| Last updated | Apr 4th, 2014 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1467483628 | NPPES |
| Washington | MEDICAID | 8168650 |
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