Active NPI
Cincy Lee, PHARM D
- Pharmacist
- Portland, OR
National Provider Identifier
1295008316
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11159
- Practice address
- 5050 NE Hoyt St Ste 142
Portland, OR 97213-2956 - Phone
- (503) 215-6296
- Fax
- (503) 215-6459
- NPI assigned
- Feb 21, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 11159 | OR | Primary |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 11159 | OR |
Addresses
Primary practice location
5050 NE Hoyt St Ste 142
Portland, OR 97213-2956
Mailing address
5050 NE Hoyt St Ste 142
Portland, OR 97213-2956
Phone (503) 215-6296
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | cincy.lee@providence.org | Credena Health LLC |
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11159 | OR | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fred Meyer Stores Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Retail Pharmacy
- Portland, OR
- NPI 1902841075
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701043200000",
"number": "1295008316",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5050 NE HOYT ST STE 142",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972132956",
"telephone_number": "503-215-6296",
"fax_number": "503-215-6459"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5050 NE HOYT ST STE 142",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972132956",
"telephone_number": "503-215-6296",
"fax_number": "503-215-6459"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "CINCY",
"credential": "PHARM D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-02-21",
"last_updated": "2023-11-27",
"certification_date": "2020-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "11159",
"primary": true
},
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "OR",
"license": "11159",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "cincy.lee@providence.org",
"affiliation": "Y",
"affiliationName": "Credena Health LLC",
"address_1": "5050 NE Hoyt St Ste 142",
"city": "Portland",
"state": "OR",
"country_code": "US",
"postal_code": "972132956",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.