Individual provider Active NPI

Jessica Kristine Lee

  • Anesthesiology Physician
  • Edmonds, WA
National Provider Identifier
1295180768
Registry record updated Jun 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
OP61171598 Issued in WA
Practice address
21601 76TH Ave W
Edmonds, WA 98026-7507
Phone
(425) 640-4000
NPI assigned
May 3, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X OP61171598 WA Primary

Addresses

Primary practice location

21601 76TH Ave W
Edmonds, WA 98026-7507

Mailing address

1300 University St Apt 3G
Seattle, WA 98101-2804
Phone (951) 901-9836

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
I20210601002706 WA Practitioner - Anesthesiology 3678841301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Western University of Health Sciences College of Dental Med, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Anesthesia PCGroup PAC ID 2961399290, 91 clinicians

Practice addresses (Care Compare)

21601 76TH Ave W
Edmonds, WA 98026-7507
Phone (425) 640-4000

Hospital & facility affiliations

  • Swedish Edmonds Hospital Hospital, Edmonds, WA, CCN 500026

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OP61171598WAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Anesthesia PC Anesthesiology CurrentSince Jun 1, 2021 Accepting new patients

Locations

11808 Northup Way
Ste W300
Bellevue, WA 98005
Phone (425) 284-1545

21601 76th Ave W
Edmonds, WA 98026
Phone (425) 640-4000

1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101

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.

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": "1462233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1295180768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 UNIVERSITY ST APT 3G",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981012804",
            "telephone_number": "951-901-9836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21601 76TH AVE W",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267507",
            "telephone_number": "425-640-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JESSICA",
        "middle_name": "KRISTINE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-03",
        "last_updated": "2021-06-11",
        "certification_date": "2021-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "OP61171598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmonds, WA

Sources for this page

Verify at the official NPI Registry.