Active NPI
Bradley Zephaniah Lee, RN
- Registered Nurse
- Burien, WA
National Provider Identifier
1306568415
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN60855006
- Practice address
- 15675 Ambaum Blvd SW
Burien, WA 98166-2523 - Phone
- (206) 631-3251
- NPI assigned
- Sep 15, 2022
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN60855006 | WA | Primary |
Addresses
Primary practice location
15675 Ambaum Blvd SW
Burien, WA 98166-2523
Mailing address
15675 Ambaum Blvd SW
Burien, WA 98166-2523
Phone (206) 631-3251
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RN60855006 | Other | WA | RN |
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
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN60855006 | WA | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kitsap Mental Health Services | 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/Behavioral Health Agency
- Bremerton, WA
- NPI 1033268008
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663200000000",
"number": "1306568415",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15675 AMBAUM BLVD SW",
"city": "BURIEN",
"state": "WA",
"postal_code": "981662523",
"telephone_number": "206-631-3251"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15675 AMBAUM BLVD SW",
"city": "BURIEN",
"state": "WA",
"postal_code": "981662523",
"telephone_number": "206-631-3251"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "BRADLEY",
"middle_name": "ZEPHANIAH",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-09-15",
"last_updated": "2022-09-15",
"certification_date": "2022-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WA",
"license": "RN60855006",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RN",
"identifier": "RN60855006",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Burien, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.