Provider Demographics
NPI:1861193328
Name:LIM, BO (PA-C)
Entity type:Individual
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First Name:BO
Middle Name:
Last Name:LIM
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:13800 NEWCASTLE GOLF CLUB RD APT 430
Mailing Address - Street 2:
Mailing Address - City:NEWCASTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98059-3341
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11800 NE 128TH ST STE 100
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-7208
Practice Address - Country:US
Practice Address - Phone:425-899-4500
Practice Address - Fax:425-899-4510
Is Sole Proprietor?:No
Enumeration Date:2023-03-13
Last Update Date:2024-09-05
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Provider Licenses
StateLicense IDTaxonomies
WA363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical