Individual provider Active NPI

Haki K Lee, FNP-C

  • Family Nurse Practitioner
  • Gresham, OR
National Provider Identifier
1710442926
Registry record updated May 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201900881NP-PP Issued in OR
Practice address
2850 SE Powell Valley Rd
Gresham, OR 97080-1494
Phone
(503) 666-5050
Fax
(503) 666-1162
NPI assigned
Feb 1, 2019
Last updated
May 21, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 201900881NP-PP OR Primary
Family Medicine Physician 207Q00000X 201900881 OR
Internal Medicine Physician 207R00000X 201900881NP-PP OR

Addresses

Primary practice location

2850 SE Powell Valley Rd
Gresham, OR 97080-1494

Mailing address

PO Box 3777
Portland, OR 97208-3777
Phone (503) 413-3900

Other practice location 1

14406 NE 20th Ave
Vancouver, WA 98686-1448
Phone (800) 813-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190328001190 OR Practitioner - Nurse Practitioner 8820338825 Reassigns benefits to 2 organizations
I20220420002680 WA Practitioner - Nurse Practitioner 8820338825 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Icco LLCGroup PAC ID 1355406729, 133 clinicians

Practice addresses (Care Compare)

1800 Coburg Rd
Eugene, OR 97401-4995
Phone (541) 345-8760

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
201900881ORMDFamily Medicine Physician
201900881NP-PPORMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest Family Medicine CurrentSince Feb 14, 2022 Accepting new patients
Rogue Valley Physicians PC Family Medicine CurrentSince Feb 4, 2019 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Family Medicine CurrentSince Feb 14, 2022 Accepting new patients
Icco, LLC Current Accepting new patients
Rogue Valley Physicians CurrentSince Feb 4, 2019 Accepting new patients
Icco, LLC CurrentSince Apr 21, 2025 Accepting new patients
Rogue Valley Physicians Family Medicine Current Accepting new patients
Icco LLC CurrentSince Apr 21, 2025 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Feb 14, 2022 Accepting new patients
Icco, LLC Family Medicine Past Accepting new patients

Locations (25 of 32)

108 NW Sisemore St
Ste 120
Bend, OR 97703
Phone (541) 213-2133

1302 NE 3rd St
Bend, OR 97701
Phone (541) 385-6388

615 S 2nd St
Central Point, OR 97502
Phone (541) 789-4004

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

1445 Gateway Blvd
Cottage Grove, OR 97424
Phone (541) 767-3023

186 W Ellendale Ave
Dallas, OR 97338
Phone (971) 900-4984

1800 Coburg Rd
Eugene, OR 97401
Phone (541) 342-1632

2710 Willamette St
Eugene, OR 97405
Phone (541) 735-3161

4040 W 11th Ave
Ste B
Eugene, OR 97402
Phone (458) 215-2311

598 E 13th Ave
Eugene, OR 97401
Phone (541) 636-3473

3675 Pacific Ave
#101
Forest Grove, OR 97116
Phone (971) 762-4611

1890 NW 6th St
Grants Pass, OR 97526
Phone (541) 507-0684

1623 N 1st St
Hermiston, OR 97838
Phone (458) 300-9014

355 W 3rd Ave
Junction City, OR 97448
Phone (541) 998-2468

3737 Shasta Way
Ste A
Klamath Falls, OR 97603
Phone (541) 883-2337

3400 Cooperative Way
Lebanon, OR 97355
Phone (541) 333-6605

1755 SW Baker St
McMinnville, OR 97128
Phone (971) 900-4522

1841 E Barnett Rd
Medford, OR 97504
Phone (541) 216-7291

2900 Doctors Park Dr
Ste 200
Medford, OR 97504
Phone (541) 282-2200

2900 Doctors Park Dr
Ste 250
Medford, OR 97504
Phone (541) 282-2208

1226 Virginia Ave
North Bend, OR 97459
Phone (541) 305-4224

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

1555 S Highway 97
#101
Redmond, OR 97756
Phone (541) 204-4304

3818 SW 21st St
Ste 100
Redmond, OR 97756
Phone (541) 548-2899

1740 NW Goetz St
Roseburg, OR 97471
Phone (541) 672-4789

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1548979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779321600000",
    "number": "1710442926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3777",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083777",
            "telephone_number": "503-413-3900",
            "fax_number": "503-413-3710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 SE POWELL VALLEY RD",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970801494",
            "telephone_number": "503-666-5050",
            "fax_number": "503-666-1162"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14406 NE 20th Ave",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986861448",
            "country_code": "US",
            "telephone_number": "800-813-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "HAKI",
        "middle_name": "K",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-01",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201900881NP-PP",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "201900881",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "201900881NP-PP",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

Verify at the official NPI Registry.