Individual provider Active NPI

Seunghyun Lee, MD

  • Physical Medicine & Rehabilitation Physician
  • Everett, WA
National Provider Identifier
1356435184
Registry record updated May 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
MD00046997 Issued in WA
Practice address
1330 Rockefeller Ave
Suite 230
Everett, WA 98201-1684
Phone
(425) 261-4940
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X MD00046997 WA Primary

Addresses

Primary practice location

1330 Rockefeller Ave
Suite 230
Everett, WA 98201-1684

Mailing address

PO Box 3360
Portland, OR 97208-3360
Phone (866) 366-2983

Other practice location 1

916 Pacific Ave Fl 2
Everett, WA 98201-4147
Phone (425) 261-4910

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address slee122093@wm.providencedirect.org Direct

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
I20070924000445 WA Practitioner - Physical Medicine and Rehabilitation 6002919636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Services- WashingtonGroup PAC ID 8325100480, 527 clinicians

Practice addresses (Care Compare)

1717 13TH St
Everett, WA 98201-1621

19200 N Kelsey St
Monroe, WA 98272-1431
Phone (360) 794-7994

4112 Harbour Pointe Blvd SW
Suite 100
Mukilteo, WA 98275-5457
Phone (425) 347-6330

Hospital & facility affiliations

  • Providence Regional Medical Center Everett Hospital, Everett, WA, CCN 500014

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services- Washington CurrentSince Jan 1, 2009 Accepting new patients
Providence Health & Services - Washington Past Accepting new patients

Locations

900 Pacific Ave
Ste 501
Everett, WA 98201
Phone (425) 258-7550

1321 Colby Ave
Ofc
Everett, WA 98201
Phone (425) 261-4076

916 Pacific Ave
Fl 2
Everett, WA 98201
Phone (425) 261-4910

1330 Rockefeller Ave
Ste 230
Everett, WA 98201
Phone (425) 261-4925

5007 Claremont Way
Everett, WA 98203
Phone (425) 258-7050

1717 13th St
Ste 401
Everett, WA 98201
Phone (425) 261-4910

19200 N Kelsey St
Monroe, WA 98272
Phone (360) 794-5555

4112 Harbour Pointe Blvd SW
Ste 100
Mukilteo, WA 98275
Phone (425) 347-6330

Interoperability endpoints

  • Direct secure messaging: slee122093@wm.providencedirect.org

Organizations & group practices 2

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1356435184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3360",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083360",
            "telephone_number": "866-366-2983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 ROCKEFELLER AVE",
            "address_2": "SUITE 230",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982011684",
            "telephone_number": "425-261-4940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "916 Pacific Ave Fl 2",
            "address_purpose": "LOCATION",
            "city": "Everett",
            "state": "WA",
            "postal_code": "982014147",
            "country_code": "US",
            "telephone_number": "425-261-4910",
            "fax_number": "425-261-4957",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "SEUNGHYUN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WA",
            "license": "MD00046997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "slee122093@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "916 Pacific Ave Fl 2",
            "city": "Everett",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982014147",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.