Provider Demographics
NPI:1932214384
Name:LIM, LEI Y (MD)
Entity Type:Individual
Prefix:
First Name:LEI
Middle Name:Y
Last Name:LIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 34888
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-1888
Mailing Address - Country:US
Mailing Address - Phone:425-977-4620
Mailing Address - Fax:425-745-9836
Practice Address - Street 1:21600 HIGHWAY 99
Practice Address - Street 2:SUITE 260
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-8012
Practice Address - Country:US
Practice Address - Phone:425-774-2650
Practice Address - Fax:425-774-2643
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01067717A207RG0100X
WAMD60363646207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2030035Medicaid
WA0317311OtherLABOR AND INDUSTRIES
WA0317311OtherLABOR AND INDUSTRIES