Provider Demographics
NPI:1952463713
Name:LUM-REESER, AKUA (LMP)
Entity Type:Individual
Prefix:
First Name:AKUA
Middle Name:
Last Name:LUM-REESER
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1018 E NORA AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99207-2463
Mailing Address - Country:US
Mailing Address - Phone:509-868-7621
Mailing Address - Fax:
Practice Address - Street 1:1018 E NORA AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-2463
Practice Address - Country:US
Practice Address - Phone:509-868-7621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00018287174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist