Southlake Clinic INC Ps
NPI #1043368426 in Renton, Washington
Provider Information
- NPI Number
- 1043368426
- Entity Type
- Organization
- Organization Name
- Southlake Clinic INC Ps
- Primary Specialty
- Clinic/Center - Ambulatory Surgical
- Enumeration Date
- Jan 8, 2007
- Last Updated
- Nov 20, 2012
Practice Location
- Address
- 4011 TALBOT ROAD SOUTH
- Address 2
- SUITE 500
- City
- Renton
- State
- Washington
- ZIP Code
- 98055
- Phone
- (425) 251-5110
Authorized Official
- Name
- MARIANNE LARSON
- Title
- DIRECTOR OF OPERATIONS
- Phone
- (425) 251-5110
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Endoscopy — Endoscopy |
| Clinic/Center - Ambulatory Surgical — Ambulatory Surgical |
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