Individual provider Active NPI

Ju Won Lee

  • Pharmacist
  • Phoenix, AZ
National Provider Identifier
1568854982
Registry record updated Aug 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S023556 Issued in AZ
Practice address
8809 S Pointe Pkwy E Apt 1144
Phoenix, AZ 85044-7759
Phone
(720) 933-1448
NPI assigned
Feb 22, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH60472209 WA
Pharmacist 183500000X S023556 AZ Primary

Addresses

Primary practice location

8809 S Pointe Pkwy E Apt 1144
Phoenix, AZ 85044-7759

Mailing address

8809 S Pointe Pkwy E Apt 1144
Phoenix, AZ 85044-7759
Phone (720) 933-1448

Other practice location 1

3003 Queensgate Dr # 7-255
Richland, WA 99352-7512
Phone (720) 933-1448

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
S023556AZMDPharmacist
PH60472209WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1424563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598313600000",
    "number": "1568854982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8809 S POINTE PKWY E APT 1144",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850447759",
            "telephone_number": "720-933-1448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8809 S POINTE PKWY E APT 1144",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850447759",
            "telephone_number": "720-933-1448"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3003 Queensgate Dr # 7-255",
            "address_purpose": "LOCATION",
            "city": "Richland",
            "state": "WA",
            "postal_code": "993527512",
            "country_code": "US",
            "telephone_number": "720-933-1448",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "JU WON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-02-22",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH60472209",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S023556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.