Provider Demographics
NPI:1568895175
Name:LUM, JOSHUA DAVID (MD)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:DAVID
Last Name:LUM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:550 GAGE BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-9532
Mailing Address - Country:US
Mailing Address - Phone:509-942-3125
Mailing Address - Fax:509-585-8173
Practice Address - Street 1:3900 S ZINTEL WAY FL 2
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99337-5092
Practice Address - Country:US
Practice Address - Phone:509-942-3125
Practice Address - Fax:509-585-8173
Is Sole Proprietor?:No
Enumeration Date:2013-08-19
Last Update Date:2020-08-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAMD60966705207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine