Provider Demographics
NPI:1548059850
Name:LUMEN ENDOCRINOLOGY PLLC
Entity type:Organization
Organization Name:LUMEN ENDOCRINOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEAN JACQUES
Authorized Official - Middle Name:S
Authorized Official - Last Name:NYA-NGATCHOU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:209-426-9799
Mailing Address - Street 1:10521 19TH AVE SE STE 100
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-4283
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10521 19TH AVE SE STE 100
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-4283
Practice Address - Country:US
Practice Address - Phone:209-426-9799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-02
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty