Individual provider Active NPI

Vicky Lee, NP

  • Family Nurse Practitioner
  • Tacoma, WA
National Provider Identifier
1023667052
Registry record updated Apr 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP60992364 Issued in WA
Practice address
9040 Jackson Ave
Tacoma, WA 98431-7457
Phone
(253) 968-2252
NPI assigned
Sep 11, 2019
Last updated
Apr 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP60992364 WA Primary

Addresses

Primary practice location

9040 Jackson Ave
Tacoma, WA 98431-7457

Mailing address

9040 Jackson Ave
Tacoma, WA 98431-0001
Phone (253) 968-2252

Other practice location 1

3622 Ensign Rd NE
Olympia, WA 98506-5081
Phone (360) 742-5000

Other identifiers 1

IdentifierTypeStateIssuer
2154753MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200604003055 WA Practitioner - Nurse Practitioner 1456772151 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington CurrentSince Oct 18, 2023 Accepting new patients
Sea Mar Community Health Centers CurrentSince Apr 1, 2025 Accepting new patients
Multicare Health System Current Accepting new patients
Carbon Health Medical Group of Florida PA CurrentSince Apr 15, 2024 Accepting new patients
Sea Mar Community Health Centers CurrentSince Apr 1, 2025 Accepting new patients
Multicare Health System CurrentSince Aug 31, 2022 Accepting new patients
Carbon Health Medical Group of Florida PA CurrentSince Apr 15, 2024 Accepting new patients
Sea Mar Community Health Centers Family Current Accepting new patients
Multicare Health System CurrentSince Aug 31, 2022 Accepting new patients
Providence Health & Services Washington CurrentSince Oct 18, 2023 Accepting new patients
JKW Medical Group PastSince Oct 9, 2022 Accepting new patients

Locations

11100 NE 6th St
Bellevue, WA 98004
Phone (206) 350-7345

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

13210 39th Ave SE
Unit 102
Mill Creek, WA 98012
Phone (425) 216-6955

1620 Cooper Point Rd SW
Olympia, WA 98502
Phone (360) 486-6710

525 Lilly Rd NE
Olympia, WA 98506
Phone (360) 413-8550

3030 Limited Ln NW
Olympia, WA 98502
Phone (360) 352-6000

3622 Ensign Rd NE
Olympia, WA 98506
Phone (360) 570-8016

10221 156th St E
Ste P1102
Puyallup, WA 98374
Phone (253) 292-5297

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1568160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745539200000",
    "number": "1023667052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "253-968-2252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984317457",
            "telephone_number": "253-968-2252"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3622 Ensign Rd NE",
            "address_purpose": "LOCATION",
            "city": "Olympia",
            "state": "WA",
            "postal_code": "985065081",
            "country_code": "US",
            "telephone_number": "360-742-5000",
            "fax_number": "360-742-5019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "VICKY",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-11",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60992364",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2154753",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.