Individual provider Active NPI

Fang-Yu Lee, MD

  • Family Medicine Physician
  • Vancouver, WA
National Provider Identifier
1255998324
Registry record updated Sep 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD61037697 Issued in WA
Practice address
3101 SE 192ND Ave Ste 106
Vancouver, WA 98683-1443
Phone
(360) 553-7400
NPI assigned
May 23, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ML60973564 WA
Family Medicine Physician 207Q00000X MD209116 OR
Family Medicine Physician 207Q00000X MD61037697 WA Primary

Addresses

Primary practice location

3101 SE 192ND Ave Ste 106
Vancouver, WA 98683-1443

Mailing address

PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494

Other practice location 1

525 Lilly Rd NE
Olympia, WA 98506-5101
Phone (360) 493-7230

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220902002678 WA Practitioner - Family Practice 8729414347 Reassigns benefits to 2 organizations
I20220902002701 OR Practitioner - Family Practice 8729414347 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
New York Medical College, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
PeacehealthGroup PAC ID 8820178288, 245 clinicians

Practice addresses (Care Compare)

3101 SE 192ND Ave
Vancouver, WA 98683-1442
Phone (360) 729-8010

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Vancouver, WA, CCN 507081
  • Peacehealth Southwest Home Health Home health agency, Vancouver, WA, CCN 507064
  • Peacehealth Southwest Medical Cente Hospital, Vancouver, WA, CCN 500050

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD209116ORMDFamily Medicine Physician
MD61037697WAMDFamily Medicine Physician
ML60973564WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth CurrentSince Dec 30, 2024 Accepting new patients
Peacehealth CurrentSince Dec 30, 2024 Accepting new patients
Providence Health & Services - Oregon CurrentSince Sep 1, 2022 Accepting new patients
Peacehealth Family Medicine CurrentSince Dec 30, 2024 Accepting new patients
Providence Health & Services Oregon CurrentSince Sep 1, 2022 Accepting new patients

Locations

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

3101 SE 192nd Ave
Vancouver, WA 98683
Phone (360) 729-8010

1115 SE 164th Ave
Dept 364
Vancouver, WA 98683
Phone (360) 735-8100

100 E 33rd St
Ste 100
Vancouver, WA 98663
Phone (360) 514-7550

3101 SE 192nd Ave
Ste 106
Vancouver, WA 98683
Phone (360) 553-7400

400 NE Mother Joseph Pl
Vancouver, WA 98664
Phone (360) 514-2000

505 NE 87th Ave
Ste 301
Vancouver, WA 98664
Phone (360) 514-1854

Interoperability endpoints

  • Direct secure messaging: flee679002@direct.peacehealth.org
  • Direct secure messaging: flee1074788@oc.providencedirect.org

Organizations & group practices 5

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 4

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": "1558569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1255998324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 SE 192ND AVE STE 106",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986831443",
            "telephone_number": "360-553-7400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525 Lilly Rd NE",
            "address_purpose": "LOCATION",
            "city": "Olympia",
            "state": "WA",
            "postal_code": "985065101",
            "country_code": "US",
            "telephone_number": "360-493-7230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "FANG-YU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-23",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "ML60973564",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD209116",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61037697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.