NPIMap

Individual provider Active NPI

Mijung Lee, MD

  • Medical Oncology Physician
  • Lacey, WA
National Provider Identifier
1093970048
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
MD61251868 Issued in WA
Practice address
4525 3Rd Ave SE Ste 200
Lacey, WA 98503-1010
Phone
(360) 754-3934
Fax
(360) 943-8023
NPI assigned
Jul 18, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X MD61251868 WA Primary

Addresses

Primary practice location

4525 3Rd Ave SE Ste 200
Lacey, WA 98503-1010

Mailing address

PO Box 3360
Portland, OR 97208-3360

Other names 1

  • Dr. Mijung Lee Former name

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
I20220826002199 WA Practitioner - Medical OncologyPractitioner - Hematology/Oncology 5991921751 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Medical OncologyAlso: Hematology/Oncology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Health and Services WashingtonGroup PAC ID 6709782600, 480 clinicians

Practice addresses (Care Compare)

4525 3Rd Ave SE
Suite 200
Lacey, WA 98503-1010
Phone (360) 754-3934

Hospital & facility affiliations

  • Providence Centralia Hospital Hospital, Centralia, WA, CCN 500019
  • Providence St Peter Hospital Hospital, Olympia, WA, CCN 500024
  • Grays Harbor Community Hospital Hospital, Aberdeen, WA, CCN 500031
  • Summit Pacific Medical Center Hospital, Elma, WA, CCN 501304
  • Mason General Hospital & Family of Clinics Hospital, Shelton, WA, CCN 501336

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington Current Accepting new patients
Providence Health & Services Washington CurrentSince Jun 20, 2022 Accepting new patients
Providence Health & Services Washington Current Accepting new patients
Providence Health & Services Washington CurrentSince Jun 20, 2022 Accepting new patients
Providence Health & Services Washington CurrentSince Jun 20, 2022 Accepting new patients
Providence Health & Services Washington CurrentSince Jun 20, 2022 Accepting new patients

Locations

914 S Scheuber Rd
Centralia, WA 98531
Phone (360) 330-8516

413 Lilly Rd NE
Olympia, WA 98506
Phone (360) 491-9480

4525 3rd Ave SE
#200
Olympia, WA 98503
Phone (360) 533-6906

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

Interoperability endpoints

  • Direct secure messaging: mlee2359668@wm.providencedirect.org

Organizations & group practices 6

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.

Hospital & facility affiliations 10

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": "1216339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1093970048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3360",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4525 3RD AVE SE STE 200",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985031010",
            "telephone_number": "360-754-3934",
            "fax_number": "360-943-8023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "MIJUNG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-18",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "WA",
            "license": "MD61251868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIJUNG",
            "last_name": "LEE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lacey, WA

Sources for this page

Verify at the official NPI Registry.