Individual
LEA SHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1701 - 3RD ST SE #300, PUYALLUP, WA 98372
(253) 697-5767
Mailing address
P.O. BOX 5299, MS: 1313-5-PCO, TACOMA, WA 98415-0299
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OP61204077
WA
Other
Enumeration date
04/13/2018
Last updated
11/15/2021
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