Individual provider Active NPI

Spencer Truman Lake, MD

  • Diagnostic Radiology Physician
  • Tacoma, WA
National Provider Identifier
1316203607
Registry record updated Oct 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD60852353 Issued in WA
Practice address
1304 Fawcett Ave Ste 100
Tacoma, WA 98402
Phone
(253) 761-4200
Fax
(253) 761-4201
NPI assigned
Apr 11, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD60852353 WA Primary
Diagnostic Radiology Physician 2085R0202X MD190332 OR

Addresses

Primary practice location

1304 Fawcett Ave Ste 100
Tacoma, WA 98402

Mailing address

PO Box 1535
Tacoma, WA 98401-1535
Phone (253) 761-4200

Other practice location 1

209 Martin Luther King Jr Way
Tacoma, WA 98405-4267
Phone (253) 596-3300

Other practice location 2

2502 S Union Ave
Tacoma, WA 98405-1328
Phone (253) 761-9482

Other practice location 3

222 15th Ave SE
Puyallup, WA 98372-3754
Phone (253) 841-4353

Other identifiers 5

IdentifierTypeStateIssuer
2101564MedicaidWA
0391227OtherWALNI-UAOM
0391226OtherWALNI-TRA KING COUNTY
0391228OtherWALNI-DINW
0391224OtherWALNI-TRA REST OF WA

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, WA2 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
I20170609001744 CA Practitioner - Diagnostic Radiology 5395994172 Reassigns benefits to 1 organization
I20180613001458 WA Practitioner - Diagnostic Radiology 5395994172 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Johns Hopkins University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

209 Martin Luther King Jr Way
Tacoma, WA 98405-4265
Phone (253) 596-3300

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington CurrentSince Aug 1, 2025 Accepting new patients
Proliance Surgeons Inc P S Current Accepting new patients
Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance CurrentSince Jul 1, 2018 Accepting new patients
Proliance Surgeons Inc P S CurrentSince Jan 7, 2022 Accepting new patients
Union Avenue Open MRI LLC CurrentSince Jul 1, 2018 Accepting new patients
Proliance Surgeons, Inc., P.S. CurrentSince Jan 7, 2022 Accepting new patients
Kaiser Foundation Health Plan of Washington Current Accepting new patients
Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance CurrentSince Jul 1, 2018 Accepting new patients
University of California SFGH Medical Group CurrentSince May 12, 2017 Accepting new patients
University of California SFGH Medical Group Diagnostic Radiology CurrentSince May 12, 2017 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Aug 1, 2025 Accepting new patients

Locations

1001 Potrero Ave
Bldg 5
San Francisco, CA 94110
Phone (628) 206-5753

510 8th Ave NE
Ste 200
Issaquah, WA 98029
Phone (425) 392-3030

222 15th Ave SE
Puyallup, WA 98372

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

1101 Madison St
Ste 580
Seattle, WA 98104
Phone (206) 400-7625

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

1304 Fawcett Ave
Ste 100
Tacoma, WA 98402
Phone (253) 680-3372

3402 S 18th St
Tacoma, WA 98405
Phone (253) 383-1099

209 Martin Luther King Jr Way
Tacoma, WA 98405
Phone (253) 596-3300

9601 Steilacoom Blvd SW
Tacoma, WA 98498
Phone (253) 582-8900

2502 S Union Ave
Tacoma, WA 98405
Phone (253) 759-5900

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • Direct secure messaging: spencer.lake.p42@direct.proliance.nextgenshare.com
  • Direct secure messaging: slake4598692@ghc.direct-ci.net

Organizations & group practices 12

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 3

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": "1334102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1316203607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1535",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984011535",
            "telephone_number": "253-761-4200",
            "fax_number": "253-383-3553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 FAWCETT AVE STE 100",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "98402",
            "telephone_number": "253-761-4200",
            "fax_number": "253-761-4201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "209 Martin Luther King Jr Way",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984054267",
            "country_code": "US",
            "telephone_number": "253-596-3300",
            "fax_number": "253-596-3301",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2502 S Union Ave",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984051328",
            "country_code": "US",
            "telephone_number": "253-761-9482",
            "fax_number": "253-759-6252",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "222 15th Ave SE",
            "address_purpose": "LOCATION",
            "city": "Puyallup",
            "state": "WA",
            "postal_code": "983723754",
            "country_code": "US",
            "telephone_number": "253-841-4353",
            "fax_number": "253-583-8630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAKE",
        "first_name": "SPENCER",
        "middle_name": "TRUMAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-11",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD60852353",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OR",
            "license": "MD190332",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2101564",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LNI-UAOM",
            "identifier": "0391227",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LNI-TRA KING COUNTY",
            "identifier": "0391226",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LNI-DINW",
            "identifier": "0391228",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LNI-TRA REST OF WA",
            "identifier": "0391224",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "209 Martin Luther King Jr Way",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984054267",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.