Provider Demographics
NPI:1528126448
Name:LIM, LOUIS W (MD)
Entity type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:W
Last Name:LIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3600 LIND AVE SW STE 100
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-4970
Mailing Address - Country:US
Mailing Address - Phone:425-690-2715
Mailing Address - Fax:
Practice Address - Street 1:3600 LIND AVE SW STE 170
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-4934
Practice Address - Country:US
Practice Address - Phone:425-656-5020
Practice Address - Fax:425-656-5019
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD600808332083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
110241037OtherRAILROAD MEDICARE
MO205901309Medicaid
WA2012986Medicaid
431560263021OtherTRICARE
WAG9003767OtherMEDICARE