Individual provider Active NPI

Jacklyn Lee, D.O.

  • Family Medicine Physician
  • Edmonds, WA
National Provider Identifier
1376030031
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OP61116552 Issued in WA
Practice address
7315 212TH St SW Ste 101
Edmonds, WA 98026-7610
Phone
(425) 775-9474
Fax
(425) 670-3554
NPI assigned
Apr 18, 2018
Last updated
Oct 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X OP61116552 WA Primary

Addresses

Primary practice location

7315 212TH St SW Ste 101
Edmonds, WA 98026-7610

Mailing address

PO Box 741515
Los Angeles, CA 90074-1515

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jlee36285@skagit.direct-ci.com 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
I20210916001248 WA Practitioner - Family PracticePractitioner - Other (Physician) 8325395759 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Touro Un Col of Osteopathic Medicine, Henderson, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Virginia Mason Medical CenterGroup PAC ID 9830002617, 867 clinicians

Practice addresses (Care Compare)

1100 9TH Ave
Seattle, WA 98101-2756
Phone (206) 223-6600

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital Dist No 1 Skagit Current Accepting new patients
Public Hospital Dist No 1 Skagit CurrentSince Aug 30, 2021 Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Public Hospital Dist No 1 Skagit CurrentSince Aug 30, 2021 Accepting new patients
Virginia Mason Medical Center CurrentSince Jul 24, 2025 Accepting new patients
Virginia Mason Medical Center Family Medicine CurrentSince Jul 24, 2025 Accepting new patients

Locations

3823 172nd St NE
Arlington, WA 98223
Phone (360) 618-5000

7530 204th St NE
Arlington, WA 98223
Phone (360) 435-7337

380 Winslow Way E
Bainbridge Island, WA 98110
Phone (206) 842-5632

7315 212th St SW
Ste 101
Edmonds, WA 98026
Phone (425) 670-3550

1400 E Kincaid St
Mount Vernon, WA 98274
Phone (360) 428-2586

1100 9th Ave
Seattle, WA 98101
Phone (206) 223-6980

925 Seneca St
Seattle, WA 98101
Phone (206) 341-0860

Interoperability endpoints

  • Direct secure messaging: jlee36285@skagit.direct-ci.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1524009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1376030031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 741515",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900741515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7315 212TH ST SW STE 101",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267610",
            "telephone_number": "425-775-9474",
            "fax_number": "425-670-3554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JACKLYN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-18",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP61116552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jlee36285@skagit.direct-ci.com",
            "affiliation": "N",
            "endpointDescription": "Provider Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7530 204th St NE",
            "city": "Arlington",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982238912",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Edmonds, WA

Sources for this page

Verify at the official NPI Registry.