Diane Phan Lee, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

H7100 Issued in OR

Practice address

9151 SE Woodstock Blvd
Portland, OR 97266-5369

Phone

(503) 433-2414

NPI assigned

Jun 4, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Diane Phan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1559606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683763200000",
    "number": "1710545710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6004 NE 51ST AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986611865",
            "telephone_number": "503-821-9030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9151 SE WOODSTOCK BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972665369",
            "telephone_number": "503-433-2414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "DIANE",
        "middle_name": "PHAN",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-04",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "OR",
            "license": "H7100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANE",
            "last_name": "PHAN",
            "credential": "RDH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• David Michael Lee, MD
• Deanna L Lee, D.M.D.
• Deborah Lee, MD
• Debrah Lee, LCSW
• Devita Lee
• Dmon Lamarcus Lee
• Donnie Lee, M.D.
• Elizabeth Lee
• Ellen Lee, O.D.
• Ellisha Lee, RPH

• Dental Hygienist in Portland, OR
• Providers in Portland, OR by specialty
• Dental Hygienist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.