Active NPI
Inkyu Lee
- Pharmacist
- Everett, WA
National Provider Identifier
1851611198
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH60188356
- Practice address
- 11031 19TH Ave SE # Ace
Everett, WA 98208-5144 - Phone
- (425) 337-0684
- NPI assigned
- Jun 9, 2010
- Last updated
- Jun 28, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 63690 | CA | |
| Pharmacist | 183500000X | PH60188356 | WA | Primary |
Addresses
Primary practice location
11031 19TH Ave SE # Ace
Everett, WA 98208-5144
Mailing address
8156 NE 117TH PL
Kirkland, WA 98034-3579
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 |
|---|---|---|---|
| 63690 | CA | MD | Dentist |
| PH60188356 | WA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Safeway Inc | Past | Accepting new patients | |
| Safeway Inc | Past | Accepting new patients |
Organizations & group practices 2
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": "1276041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340841600000",
"number": "1851611198",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8156 NE 117TH PL",
"city": "KIRKLAND",
"state": "WA",
"postal_code": "980343579"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11031 19TH AVE SE # ACE",
"city": "EVERETT",
"state": "WA",
"postal_code": "982085144",
"telephone_number": "425-337-0684"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "INKYU",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-06-09",
"last_updated": "2012-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "63690",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH60188356",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.