MEDICARE: DR. LOUIS W. LIM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2083X0100X	Occupational Medicine Physician	MD60080833	WA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	110241037	OTHER		RAILROAD MEDICARE
5	G9003767	OTHER	WA	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	431560263021	OTHER	TRICARE

General Provider Information

NPI Number	:	1528126448
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LOUIS W. LIM MD

Provider Business Mailing Address
First Line	:	3600 LIND AVE SW STE 100
Second Line	:
City	:	RENTON
State	:	WA
Zip	:	98057-4970
Country	:	US
Telephone Number	:	425-690-2715
Fax Number	:

Provider Business Practice Location Address
First Line	:	3600 LIND AVE SW STE 170
Second Line	:
City	:	RENTON
State	:	WA
Zip	:	98057-4934
Country	:	US
Telephone Number	:	425-656-5020
Fax Number	:	425-656-5019

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/04/2006
Last Update Date	:	01/16/2020

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Directions to “ DR. LOUIS W. LIM MD” Practice Location

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