Individual provider Active NPI

Changho Yi, MD

  • Interventional Pain Medicine Physician
  • Lakewood, WA
National Provider Identifier
1619618998
Registry record updated Mar 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
MD61616683 Issued in WA
Practice address
11306 Bridgeport Way SW Ste D
Lakewood, WA 98499-3037
Phone
(253) 983-9390
NPI assigned
Apr 2, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X MD61616683 WA Primary

Addresses

Primary practice location

11306 Bridgeport Way SW Ste D
Lakewood, WA 98499-3037

Mailing address

4029 Northwest Ave Ste 301
Bellingham, WA 98226-9077
Phone (253) 983-9390

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
I20260402001211 WA Practitioner - Pain Management 3577085935 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain Management
Education
Other, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4029 Northwest Ave
Suite 301
Bellingham, WA 98226-9077

National Provider Directory

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

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": "1648857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773878400000",
    "number": "1619618998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4029 NORTHWEST AVE STE 301",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982269077",
            "telephone_number": "253-983-9390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11306 BRIDGEPORT WAY SW STE D",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984993037",
            "telephone_number": "253-983-9390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YI",
        "first_name": "CHANGHO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-02",
        "last_updated": "2026-03-19",
        "certification_date": "2026-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "WA",
            "license": "MD61616683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

Verify at the official NPI Registry.