Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204E00000X | Oral & Maxillofacial Surgeon | DE60812299 | WA |
N | 204E00000X | Oral & Maxillofacial Surgeon | DR60753961 | WA |
NPI | 1265972293 |
---|---|
Provider Name | Dr. Rachel Bobae Lim |
First Address | Rancho Palos Verdes, CA 90275-4535 |
Second Address | Seattle, WA 98195-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2017 |
Last Update Date | 07/02/2018 |