Active NPI
Scott William Lee, PH.D.
- Clinical Psychologist
- Kirkland, WA
National Provider Identifier
1518040732
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 988
- Practice address
- 12412 NE 112TH PL
Kirkland, WA 98033-4111 - Phone
- (425) 821-3966
- Fax
- (425) 821-3966
- NPI assigned
- Oct 23, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 988 | WA | Primary |
Addresses
Primary practice location
12412 NE 112TH PL
Kirkland, WA 98033-4111
Mailing address
12412 NE 112TH PL
Kirkland, WA 98033-4111
Phone (425) 821-3966
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130917000168 | WA | Practitioner - Clinical Psychologist | 5890939649 | Practice locations: Kirkland, WA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
12412 NE 112TH PL
Kirkland, WA 98033-4111
Phone (425) 821-3966
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 988 | WA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1355184000000",
"number": "1518040732",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12412 NE 112TH PL",
"city": "KIRKLAND",
"state": "WA",
"postal_code": "980334111",
"telephone_number": "425-821-3966",
"fax_number": "425-821-3966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12412 NE 112TH PL",
"city": "KIRKLAND",
"state": "WA",
"postal_code": "980334111",
"telephone_number": "425-821-3966",
"fax_number": "425-821-3966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "SCOTT",
"middle_name": "WILLIAM",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-23",
"last_updated": "2012-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "988",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kirkland, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.