Provider Demographics
NPI:1851588750
Name:LEWIS S LIM AND ASSOCIATES OD PS
Entity Type:Organization
Organization Name:LEWIS S LIM AND ASSOCIATES OD PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEWIS
Authorized Official - Middle Name:SENG
Authorized Official - Last Name:LIM
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:253-852-5440
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3736TX152W00000X, 152WC0802X, 152WL0500X, 152WP0200X, 152WS0006X, 152WV0400X, 152WX0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision RehabilitationGroup - Single Specialty
No152WP0200XEye and Vision Services ProvidersOptometristPediatricsGroup - Single Specialty
No152WS0006XEye and Vision Services ProvidersOptometristSports VisionGroup - Single Specialty
No152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Single Specialty
No152WX0102XEye and Vision Services ProvidersOptometristOccupational VisionGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2017499Medicaid
WAG8859572Medicare PIN