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LAKESHORE CLINIC PLLC NPI 1346345972


NPI Information

NPI: 1346345972
Provider Name: LAKESHORE CLINIC PLLC

Other Name: LAKESHORE CLINIC TOTEM LAKE

Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
12710 TOTEM LAKE BLVD NE
KIRKLAND, WA
ZIP 98034
Phone: (425) 821-4040
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LAKESHORE CLINIC PLLC is a family medicine in Kirkland, WA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. LAKESHORE CLINIC PLLC NPI is 1346345972. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Lakeshore Clinic Totem Lake.

The provider's business location address is:

12710 TOTEM LAKE BLVD NE
KIRKLAND, WA
ZIP 98034-907
Phone: (425) 821-4040
Fax: (425) 820-5060

The provider's authorized official is Linda R Jeppesen .
The authorized official title is Ceo and has the following contact phone number (425) 485-3955.

The enumeration date for this NPI number is 9/14/2006 and was last updated on 10/11/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal MedicineNo
2213E00000XPodiatristNo
3207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10812480002MEDICARE NSCWASHINGTON
2217116700MEDICARE ID-TYPE UNSPECIFIEDMEDICARE GROUP NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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