Individual provider Active NPI

Linda Lee, PSY.D.

  • Clinical Psychologist
  • Vancouver, WA
National Provider Identifier
1912281254
Registry record updated Feb 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY60234783 Issued in WA
Practice address
13220 NW 33Rd Ave
Vancouver, WA 98685-2288
Phone
(360) 334-6301
Fax
(360) 334-6307
NPI assigned
Oct 5, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 4165 AZ
Clinical Psychologist 103TC0700X 9619 MA
Clinical Psychologist 103TC0700X PY60234783 WA Primary

Addresses

Primary practice location

13220 NW 33Rd Ave
Vancouver, WA 98685-2288

Mailing address

PO Box 65523
Vancouver, WA 98665-0018
Phone (360) 334-6301

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111110000924 WA Practitioner - Clinical Psychologist 2668646514 Practice locations: Vancouver, WA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

13220 NW 33Rd Ave
Vancouver, WA 98685-2288

13220 NW 33Rd Ave Lower Level
Vancouver, WA 98685-2288

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9619MAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1317772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1912281254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 65523",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986650018",
            "telephone_number": "360-334-6301",
            "fax_number": "360-334-6307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13220 NW 33RD AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986852288",
            "telephone_number": "360-334-6301",
            "fax_number": "360-334-6307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "LINDA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-05",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "4165",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "9619",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY60234783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.