Individual provider Active NPI

Jaimie Marie Lee, MSW, LICSW, LCSW

  • Clinical Social Worker
  • Portland, OR
National Provider Identifier
1639340383
Registry record updated Jan 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
113886 Issued in MA
Practice address
426 SW Stark St FL 5
Westside Clinic
Portland, OR 97204-2347
Phone
(503) 988-5140
NPI assigned
Mar 20, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 113886 MA Primary

Addresses

Primary practice location

426 SW Stark St FL 5
Westside Clinic
Portland, OR 97204-2347

Mailing address

426 SW Stark St FL 5
Westside Clinic
Portland, OR 97204-2347
Phone (503) 988-5140

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
113886MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1205971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264032000000",
    "number": "1639340383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 SW STARK ST FL 5",
            "address_2": "WESTSIDE CLINIC",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972042347",
            "telephone_number": "503-988-5140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 SW STARK ST FL 5",
            "address_2": "WESTSIDE CLINIC",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972042347",
            "telephone_number": "503-988-5140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JAIMIE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MSW, LICSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-20",
        "last_updated": "2010-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "113886",
            "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 21, 2010; 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.