NPIMap

Individual provider Active NPI

Edward Sungwon Lee, DO

  • Family Medicine Physician
  • Kirkland, WA
National Provider Identifier
1033134267
Registry record updated Apr 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OP60219951 Issued in WA
Practice address
11800 NE 128TH St FL 5
Kirkland, WA 98034-7208
Phone
(425) 899-5200
Fax
(425) 899-5204
NPI assigned
Jul 12, 2006
Last updated
Apr 23, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OP60219951 WA Primary
Family Medicine Physician 207Q00000X 036109991 IL

Addresses

Primary practice location

11800 NE 128TH St FL 5
Kirkland, WA 98034-7208

Mailing address

7600 Evergreen Way
Everett, WA 98203-6421
Phone (206) 860-5414

Other practice location 1

2902 164th St SW
Bldg E1
Lynnwood, WA 98087-3201
Phone (425) 741-7750

Other identifiers 3

IdentifierTypeStateIssuer
834340022OtherILMEDICARE PTAN
834340OtherILMEDICARE GROUP PTAN
834370OtherILMEDICARE GROUP #

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address elee122233@wm.providencedirect.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111103000930 WA Practitioner - Osteopathic Manipulative MedicinePractitioner - Family Practice 9931008141 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative Medicine
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optum Care Washington PLLCGroup PAC ID 6406752153, 684 clinicians
Select Outpatient Services IncGroup PAC ID 4082868815, 750 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

11800 NE 128TH St
Suite 560
Kirkland, WA 98034-7208
Phone (425) 899-5200

2600 Compass Rd
Glenview, IL 60026-8001

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
036109991ILMDFamily Medicine Physician
OP60219951WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Polyclinic CurrentSince Jan 16, 2024 Accepting new patients
The Polyclinic PLLC Family Medicine Current Accepting new patients
Optum Care Washington PLLC Family Medicine CurrentSince Jan 16, 2024 Accepting new patients
Optum Care Washington PLLC Family Medicine CurrentSince Jan 16, 2024 Accepting new patients
The Polyclinic PLLC Family Medicine CurrentSince Jan 16, 2024 Accepting new patients
Optum Care Washington PLLC Past Accepting new patients

Locations

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

11800 NE 128th St
Ste 560
Kirkland, WA 98034
Phone (425) 899-5200

1145 Broadway
Seattle, WA 98122

9709 3rd Ave NE
Seattle, WA 98115
Phone (206) 525-5777

1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299

1812 S J St
Ste 102
Tacoma, WA 98405
Phone (253) 552-4900

Interoperability endpoints

  • Direct secure messaging: elee122233@wm.providencedirect.org
  • Direct secure messaging: elee82974@direct.tecmc.com
  • FHIR API: https://api.platform.athenahealth.com/3889/brand/1/csg/1/fhir/r4

Organizations & group practices 7

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776902400000",
    "number": "1033134267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 EVERGREEN WAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982036421",
            "telephone_number": "206-860-5414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11800 NE 128TH ST FL 5",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980347208",
            "telephone_number": "425-899-5200",
            "fax_number": "425-899-5204"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2902 164th St SW",
            "address_2": "Bldg E1",
            "address_purpose": "LOCATION",
            "city": "Lynnwood",
            "state": "WA",
            "postal_code": "980873201",
            "country_code": "US",
            "telephone_number": "425-741-7750",
            "fax_number": "425-678-4680",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "EDWARD",
        "middle_name": "SUNGWON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2026-04-23",
        "certification_date": "2026-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP60219951",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036109991",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "834340022",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "834340",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP #",
            "identifier": "834370",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "elee122233@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2902 164th St SW",
            "address_2": "Bldg E1",
            "city": "Lynnwood",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980873201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

Verify at the official NPI Registry.