Individual provider Active NPI

Jenny Le, D.O

  • Family Medicine Physician
  • Renton, WA
National Provider Identifier
1255866471
Registry record updated Sep 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OP61062323 Issued in WA
Practice address
601 S Carr Rd Ste 100
Renton, WA 98055-5802
Phone
(425) 227-3700
NPI assigned
Apr 25, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OP61062323 WA Primary

Addresses

Primary practice location

601 S Carr Rd Ste 100
Renton, WA 98055-5802

Mailing address

601 S Carr Rd Ste 100
Renton, WA 98055-5802
Phone (425) 227-3700

Other practice location 1

1415 E. Kincaid Street
Mount Vernon, WA 98274
Phone (360) 424-4111

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200826001042 WA Practitioner - Family Practice 4587918131 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Pacific NW Un of HS, Col of Osteopathic Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacmed ClinicsGroup PAC ID 2466350657, 211 clinicians

Practice addresses (Care Compare)

12910 Totem Lake Blvd NE
Suite 101
Kirkland, WA 98034-2901
Phone (425) 814-5000

Hospital & facility affiliations

  • Valley Medical Center Hospital, Renton, WA, CCN 500088

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
OP61062323WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pacmed Clinics CurrentSince Oct 12, 2020 Accepting new patients
Pacmed Clinics Current Accepting new patients

Locations

12910 Totem Lake Blvd NE
Ste 101
Kirkland, WA 98034
Phone (425) 814-5000

220 15th Ave SE
Puyallup, WA 98372
Phone (253) 435-3400

1801 Lind Ave SW
Bldg D
Renton, WA 98057
Phone (425) 227-3700

601 S Carr Rd
Ste 100
Renton, WA 98055
Phone (425) 227-3700

1200 12th Ave S
Seattle, WA 98144
Phone (206) 326-2400

1101 Madison St
Ste 301
Seattle, WA 98104
Phone (206) 505-1101

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.

Hospital & facility affiliations 2

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": "1493078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1255866471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S CARR RD STE 100",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555802",
            "telephone_number": "425-227-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S CARR RD STE 100",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555802",
            "telephone_number": "425-227-3700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1415 E. Kincaid Street",
            "address_purpose": "LOCATION",
            "city": "Mount Vernon",
            "state": "WA",
            "postal_code": "98274",
            "country_code": "US",
            "telephone_number": "360-424-4111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LE",
        "first_name": "JENNY",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-25",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP61062323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.