Active NPI
Jong Il Lee, DC
- Chiropractor
- Mill Creek, WA
National Provider Identifier
1710189774
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH00034764
- Practice address
- 16030 Bothell Everett Hwy
Suite 220
Mill Creek, WA 98012-1741 - Phone
- (425) 582-1022
- Fax
- (425) 385-2230
- NPI assigned
- Jun 1, 2007
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH00034764 | WA | Primary |
Addresses
Primary practice location
16030 Bothell Everett Hwy
Suite 220
Mill Creek, WA 98012-1741
Mailing address
16030 Bothell Everett Hwy
Suite 220
Mill Creek, WA 98012-1741
Phone (425) 582-1022
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
| License | State | Type | Specialty |
|---|---|---|---|
| CH00034764 | WA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1259798400000",
"number": "1710189774",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16030 BOTHELL EVERETT HWY",
"address_2": "SUITE 220",
"city": "MILL CREEK",
"state": "WA",
"postal_code": "980121741",
"telephone_number": "425-582-1022",
"fax_number": "425-385-2230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16030 BOTHELL EVERETT HWY",
"address_2": "SUITE 220",
"city": "MILL CREEK",
"state": "WA",
"postal_code": "980121741",
"telephone_number": "425-582-1022",
"fax_number": "425-385-2230"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JONG IL",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-01",
"last_updated": "2009-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WA",
"license": "CH00034764",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mill Creek, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.