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General NPI Number Information
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NPI Number | 1548059850
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Entity Type | Organization
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Legal Business Name | LUMEN ENDOCRINOLOGY PLLC
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Dates
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Enumeration Date | 05/02/2025
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Last Update Date | 05/02/2025
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Provider Practice Location Address
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Address Line | 10521 19TH AVE SE STE 100
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City | EVERETT
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State | WA
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Zip | 98208-4283
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Country | US
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Telephone | 209-426-9799
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Fax |
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Provider Business Mailing Address
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Address Line | 10521 19TH AVE SE STE 100
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City | EVERETT
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State | WA
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Zip | 98208-4283
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JEAN JACQUES S NYA-NGATCHOU
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Credential | MD
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Telephone | 209-426-9799
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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