Individual provider Active NPI

Tina Tianyu Lee

  • Optometrist
  • Tacoma, WA
National Provider Identifier
1912757097
Registry record updated Jun 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD61546580 Issued in WA
Practice address
5821 S Sprague CT
Tacoma, WA 98409-6903
Phone
(253) 396-4200
NPI assigned
Mar 25, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD61546580 WA Primary

Addresses

Primary practice location

5821 S Sprague CT
Tacoma, WA 98409-6903

Mailing address

5821 S Sprague CT
Tacoma, WA 98409-6903

Other practice location 1

9720 4th Ave NE
Seattle, WA 98115-2143
Phone (800) 664-9225

Other practice location 2

1007 39th Ave SE
Puyallup, WA 98374-2192
Phone (425) 873-5530

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: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250716002548 WA Practitioner - Optometry 9032654223 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9800 4TH Ave NE
Seattle, WA 98115-2152
Phone (206) 527-7100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OD61546580WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington CurrentSince Jul 1, 2025 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Jul 1, 2025 Accepting new patients
Kaiser Foundation Health Plan of Washington Current Accepting new patients

Locations

1007 39th Ave SE
Puyallup, WA 98374
Phone (253) 435-3100

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

9800 4th Ave NE
Seattle, WA 98115
Phone (206) 302-1200

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

5821 S Sprague Ct
Tacoma, WA 98409
Phone (253) 396-4200

Interoperability endpoints

  • Direct secure messaging: tlee4437187@ghc.direct-ci.net

Organizations & group practices 3

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": "1711324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780790400000",
    "number": "1912757097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5821 S SPRAGUE CT",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984096903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5821 S SPRAGUE CT",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984096903",
            "telephone_number": "253-396-4200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9720 4th Ave NE",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981152143",
            "country_code": "US",
            "telephone_number": "800-664-9225",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1007 39th Ave SE",
            "address_purpose": "LOCATION",
            "city": "Puyallup",
            "state": "WA",
            "postal_code": "983742192",
            "country_code": "US",
            "telephone_number": "425-873-5530",
            "fax_number": "844-660-0690",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "TINA",
        "middle_name": "TIANYU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-25",
        "last_updated": "2026-06-07",
        "certification_date": "2026-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD61546580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.