Active NPI
Michael Lee, PA-C, MPAS
- Physician Assistant
- Tacoma, WA
National Provider Identifier
1174167423
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 9040 Jackson Ave
Tacoma, WA 98431-5318 - Phone
- (253) 968-2252
- NPI assigned
- Oct 30, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
9040 Jackson Ave
Tacoma, WA 98431-5318
Mailing address
5387 Century PL NE
Lacey, WA 98516-5457
Other practice location 1
650 Joel Dr
Fort Campbell, KY 42223-5318
Phone (270) 798-8440
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776038400000",
"number": "1174167423",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5387 CENTURY PL NE",
"city": "LACEY",
"state": "WA",
"postal_code": "985165457"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9040 JACKSON AVE",
"city": "TACOMA",
"state": "WA",
"postal_code": "984315318",
"telephone_number": "253-968-2252"
}
],
"practiceLocations": [
{
"address_1": "650 Joel Dr",
"address_purpose": "LOCATION",
"city": "Fort Campbell",
"state": "KY",
"postal_code": "422235318",
"country_code": "US",
"telephone_number": "270-798-8440",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEE",
"first_name": "MICHAEL",
"credential": "PA-C, MPAS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-10-30",
"last_updated": "2026-04-13",
"certification_date": "2026-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.