Provider Demographics
NPI:1568624989
Name:LUM-LUNG, PEPPER TOMIKO (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:PEPPER
Middle Name:TOMIKO
Last Name:LUM-LUNG
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16812 166TH PL SE
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98058-9595
Mailing Address - Country:US
Mailing Address - Phone:206-356-4511
Mailing Address - Fax:
Practice Address - Street 1:4430 TALBOT RD S
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-6218
Practice Address - Country:US
Practice Address - Phone:425-226-7500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-26
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00003670225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist