Individual provider Active NPI

Daniel Jaesuh Lee, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Everett, WA
National Provider Identifier
1467778878
Registry record updated Mar 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
MD60954929 Issued in WA
Practice address
1303 Pacific Ave
Everett, WA 98201-4234
Phone
(425) 339-5476
Fax
(425) 259-6069
NPI assigned
Apr 9, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X A 118609 CA
Physical Medicine & Rehabilitation Physician 208100000X MD60954929 WA Primary

Addresses

Primary practice location

1303 Pacific Ave
Everett, WA 98201-4234

Mailing address

PO Box 5127
Everett, WA 98206-5127
Phone (425) 304-8431

Other identifiers 1

IdentifierTypeStateIssuer
2136274MedicaidWA

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
I20190722001500 WA Practitioner - Physical Medicine and Rehabilitation 4789824020 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Care Washington PLLCGroup PAC ID 6406752153, 684 clinicians

Practice addresses (Care Compare)

1303 Pacific Ave
Everett, WA 98201-4234
Phone (425) 339-5476

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A 118609CAMDPhysical Medicine & Rehabilitation Physician
MD60954929WAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Jul 8, 2019 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Jul 8, 2019 Accepting new patients
Optum Care Washington PLLC CurrentSince Mar 14, 2022 Accepting new patients
Optum Care Washington PLLC CurrentSince Mar 14, 2022 Accepting new patients
Optum Care Washington PLLC Past Accepting new patients

Locations

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

1303 Pacific Ave
Everett, WA 98201
Phone (425) 339-5419

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

Interoperability endpoints

  • Direct secure messaging: dlee55882@direct.tecmc.com

Organizations & group practices 6

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1270771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648166400000",
    "number": "1467778878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5127",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982065127",
            "telephone_number": "425-304-8431",
            "fax_number": "805-648-9833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 PACIFIC AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014234",
            "telephone_number": "425-339-5476",
            "fax_number": "425-259-6069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "DANIEL",
        "middle_name": "JAESUH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-09",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "A 118609",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WA",
            "license": "MD60954929",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2136274",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.