Individual provider Active NPI

Jacob Lee, D.C.

  • Chiropractor
  • Maple Valley, WA
National Provider Identifier
1033969779
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
61522990 Issued in WA
Practice address
27203 216TH Ave SE Ste 1
Maple Valley, WA 98038-3273
Phone
(253) 638-2424
NPI assigned
Mar 25, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 61522990 WA Primary

Addresses

Primary practice location

27203 216TH Ave SE Ste 1
Maple Valley, WA 98038-3273

Mailing address

27203 216TH Ave SE Ste 1
Maple Valley, WA 98038-3273
Phone (253) 628-2424

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251023002812 WA Practitioner - Chiropractic 2961990601 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pearson Chiropractic PLLCGroup PAC ID 0648262428, 4 clinicians

Practice addresses (Care Compare)

27203 216TH Ave SE
Suite 1
Maple Valley, WA 98038-3273
Phone (253) 638-2424

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61522990WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Kriss Chiropractic PS Chiropractor CurrentSince Apr 13, 2025 Accepting new patients
Pearson Chiropractic PLLC CurrentSince Aug 9, 2025 Accepting new patients

Locations

15610 SE 272nd St
Ste A106
Covington, WA 98042
Phone (253) 638-2424

27203 216th Ave SE
Ste 1
Maple Valley, WA 98038
Phone (253) 638-2424

Networks

  • WA PPO C-SNP
  • devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1711324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1033969779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27203 216TH AVE SE STE 1",
            "city": "MAPLE VALLEY",
            "state": "WA",
            "postal_code": "980383273",
            "telephone_number": "253-628-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27203 216TH AVE SE STE 1",
            "city": "MAPLE VALLEY",
            "state": "WA",
            "postal_code": "980383273",
            "telephone_number": "253-638-2424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JACOB",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-25",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "61522990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Valley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.