Lee P. Wong, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY19830 Issued in CA

Practice address

12607 23Rd Ave SE
Everett, WA 98208-6691

Phone

(415) 577-2562

NPI assigned

Dec 22, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1261440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1013246057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12607 23RD AVE SE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982086691",
            "telephone_number": "415-577-2562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12607 23RD AVE SE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982086691",
            "telephone_number": "415-577-2562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "LEE",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-22",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY60537543",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY19830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alan Wong, MD
• Emily Chao Wong, NP-C
• Eric Cameron Wong, PHARM.D.
• Kelvin Karl Yu Wong, M.D.
• Kenneth Wong, RPH
• Michael Y Wong, M.D.
• Richard Frederick Wong, MSW
• San Sophie Wong
• Victor Wong
• Audrey C Woo, CRNA

• Psychologist in Everett, WA
• Providers in Everett, WA by specialty
• Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2024; 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.