Provider Demographics
NPI:1265479166
Name:LIM, LEWIS SENG (OD)
Entity Type:Individual
Prefix:DR
First Name:LEWIS
Middle Name:SENG
Last Name:LIM
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:10024 SE 240TH
Mailing Address - Street 2:STE 220
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98031-5124
Mailing Address - Country:US
Mailing Address - Phone:253-852-5440
Mailing Address - Fax:253-852-0272
Practice Address - Street 1:10024 SE 240TH ST
Practice Address - Street 2:STE 220
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98031-5124
Practice Address - Country:US
Practice Address - Phone:253-852-5440
Practice Address - Fax:253-852-0272
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WA3736TX152WC0802X, 152WL0500X, 152WP0200X, 152WS0006X, 152WX0102X, 152WV0400X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WS0006XEye and Vision Services ProvidersOptometristSports Vision
No152WX0102XEye and Vision Services ProvidersOptometristOccupational Vision
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2027357Medicaid
WA2027357Medicaid
WAG8859573Medicare PIN