Individual
KIMBERLY LU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1505 NW GILMAN BLVD, SUITE 4, ISSAQUAH, WA 98027-5398
(425) 392-8282
(425) 391-2957
Mailing address
1505 NW GILMAN BLVD, SUITE 4, ISSAQUAH, WA 98027-5398
(425) 392-8282
(425) 391-2957
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
MD00041602
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0201780
LABOR AND INDUSTRIES
WA
01
—
020750700-98065-A002
TRICARE
WA
01
—
0431LU
REGENCE BLUE SHIELD
WA
01
—
7589760
AETNA
WA
Enumeration date
07/18/2006
Last updated
01/14/2008
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