| Doctor Name: | JASON THOMAS LEE |
| NPI Number: | 1881926889 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | L.AC |
| License Number: | |
| Business Practice Address: | 6311 Wayzata Blvd Ste 240 St Louis Park, MN - 554161209 |
| Business Phone Number: | 6127592884 |
| Business Fax Number: | |
| Mailing Address: | 3209 Dupont Ave S # 2, MINNEAPOLIS |
| State: | MN |
| Postal Code: | 554083513 |
| Phone Number: | 6127472430 |
| Fax Number: | |
| NPI Enumeration Date: | 02/02/2010 |
| NPI Last Update Date: | 01/17/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225700000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Massage Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |