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General NPI Number Information
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NPI Number | 1770529489
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Entity Type | Individual
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Provider Name | LUBNA KHAN MD
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Gender | Female
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Dates
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Enumeration Date | 06/21/2006
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Last Update Date | 03/18/2019
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Provider Practice Location Address
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Address Line | 606 OAKESDALE AVE SW STE C200
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City | RENTON
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State | WA
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Zip | 98057
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Country | US
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Telephone | 866-259-1629
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Fax | 855-666-8541
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Provider Business Mailing Address
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Address Line | 606 OAKESDALE AVE SW STE C200
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City | RENTON
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State | WA
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Zip | 98057-5227
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Country | US
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Telephone | 866-259-1629
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD00038733
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License Number State | WA
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