Active NPI
Jeong Bum Lee, LMP
- Specialist
- Kent, WA
National Provider Identifier
1649571944
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MA60190442
- Practice address
- 1048 W James St Ste 104
Kent, WA 98032-4600 - Phone
- (253) 850-2800
- Fax
- (253) 850-2805
- NPI assigned
- Nov 3, 2010
- Last updated
- Nov 3, 2010
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | MA60190442 | WA | Primary |
Addresses
Primary practice location
1048 W James St Ste 104
Kent, WA 98032-4600
Mailing address
28210 51St PL S
Auburn, WA 98001-1932
Phone (206) 856-3731
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
| License | State | Type | Specialty |
|---|---|---|---|
| MA60190442 | WA | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Evergreen Massage Therapy, PS | Specialist | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Specialist
- Kent, WA
- NPI 1184996159
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288742400000",
"number": "1649571944",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28210 51ST PL S",
"city": "AUBURN",
"state": "WA",
"postal_code": "980011932",
"telephone_number": "206-856-3731"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1048 W JAMES ST STE 104",
"city": "KENT",
"state": "WA",
"postal_code": "980324600",
"telephone_number": "253-850-2800",
"fax_number": "253-850-2805"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JEONG",
"middle_name": "BUM",
"name_prefix": "Mr.",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-11-03",
"last_updated": "2010-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "MA60190442",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kent, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.