Active NPI
Calvin Yuan Wah Lee, DPT
- Physical Therapist
- Portland, OR
National Provider Identifier
1609349398
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 62918
- Practice address
- 3550 SW Bond Ave
Portland, OR 97239-4507 - Phone
- (503) 688-6400
- NPI assigned
- Jan 6, 2019
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 62918 | OR | Primary |
Addresses
Primary practice location
3550 SW Bond Ave
Portland, OR 97239-4507
Mailing address
10175 SW Windmill PL
Beaverton, OR 97008-8048
Phone (503) 891-4390
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 62918 | OR | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prestige Rehab Or LLC | Physical Therapist | Current | Accepting new patients |
Locations
5441 S Macadam Ave
Portland, OR 97239
Phone (541) 402-8932
Organizations & group practices 1
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": "1546732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546732800000",
"number": "1609349398",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10175 SW WINDMILL PL",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970088048",
"telephone_number": "503-891-4390"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3550 SW BOND AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972394507",
"telephone_number": "503-688-6400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "CALVIN",
"middle_name": "YUAN WAH",
"name_prefix": "Dr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-01-06",
"last_updated": "2019-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "62918",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.