Provider Demographics
NPI:1649377516
Name:LUM, ARTHUR BING JR (OD)
Entity type:Individual
Prefix:
First Name:ARTHUR
Middle Name:BING
Last Name:LUM
Suffix:JR
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11120 SE KENT KANGLEY RD
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98030-7708
Mailing Address - Country:US
Mailing Address - Phone:253-859-0942
Mailing Address - Fax:253-859-6345
Practice Address - Street 1:11120 SE KENT KANGLEY RD
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-7708
Practice Address - Country:US
Practice Address - Phone:253-859-0942
Practice Address - Fax:253-859-6345
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1600152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2002798Medicaid
WA2002798Medicaid