Individual provider Active NPI

Jonathan Lee, M.D.

  • Pediatrics Physician
  • Pullman, WA
National Provider Identifier
1679935530
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD60947065 Issued in WA
Practice address
1205 SE Professional Mall Blvd Ste 104
Pullman, WA 99163-5423
Phone
(509) 332-2605
NPI assigned
Mar 22, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ML60657369 WA
Pediatrics Physician 208000000X MD60947065 WA Primary

Addresses

Primary practice location

1205 SE Professional Mall Blvd Ste 104
Pullman, WA 99163-5423

Mailing address

1205 SE Professional Mall Blvd Ste 104
Pullman, WA 99163-5423
Phone (509) 332-2605

Other practice location 1

1420 S Blaine St Ste 5
Moscow, ID 83843-3973
Phone (208) 882-2247

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, ID2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20201221002892 WA Practitioner - Pediatric Medicine 4183964430 Reassigns benefits to 2 organizations
I20240416002595 ID Practitioner - Pediatric Medicine 4183964430 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital District #1-a of Whitman County CurrentSince Aug 1, 2023 Accepting new patients
Public Hospital District # 1-a Past Accepting new patients
Highline Internal Medicine PS PastSince Jul 28, 2019 Accepting new patients
Seahurst Pediatrics PLLC Pediatrics PastSince Jul 28, 2019 Accepting new patients
Public Hospital District #1-a of Whitman County Past Accepting new patients

Locations

1420 S Blaine St
Ste 5
Moscow, ID 83843
Phone (208) 882-2247

2500 W A St
Ste 201
Moscow, ID 83843
Phone (208) 332-2828

1205 SE Professional Mall Blvd
Ste 104
Pullman, WA 99163
Phone (509) 332-2605

840 SE Bishop Blvd
Ste 103
Pullman, WA 99163
Phone (509) 336-7300

825 SE Bishop Blvd
Ste 201
Pullman, WA 99163
Phone (509) 336-7577

835 SE Bishop Blvd
Pullman, WA 99163
Phone (509) 332-2541

825 SE Bishop Blvd
Ste 140
Pullman, WA 99163
Phone (509) 334-4498

840 SE Bishop Blvd
Ste 101
Pullman, WA 99163
Phone (509) 332-6139

Interoperability endpoints

  • Direct secure messaging: jlee36670@direct.seattlechildrens.org

Organizations & group practices 5

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": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1679935530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 SE PROFESSIONAL MALL BLVD STE 104",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635423",
            "telephone_number": "509-332-2605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 SE PROFESSIONAL MALL BLVD STE 104",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635423",
            "telephone_number": "509-332-2605"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1420 S Blaine St Ste 5",
            "address_purpose": "LOCATION",
            "city": "Moscow",
            "state": "ID",
            "postal_code": "838433973",
            "country_code": "US",
            "telephone_number": "208-882-2247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "JONATHAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-22",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "ML60657369",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD60947065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pullman, WA

Sources for this page

Verify at the official NPI Registry.