Southlake Clinic INC Ps
NPI #1386800753 in Renton, Washington
Provider Information
- NPI Number
- 1386800753
- Entity Type
- Organization
- Organization Name
- Southlake Clinic INC Ps
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- SOUTHLAKE CLINIC INC PS
- Primary Specialty
- Durable Medical Equipment & Medical Supplies
- Enumeration Date
- Aug 5, 2008
- Last Updated
- May 17, 2010
Practice Location
- Address
- 3915 TALBOT RD S
- Address 2
- SUITE 300
- City
- Renton
- State
- Washington
- ZIP Code
- 98055-5738
- Phone
- (425) 251-5110
Authorized Official
- Name
- MRS. MARIANNE LARSON
- Title
- CHIEF OPERATING OFFICER
- Phone
- (425) 251-5110
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies |
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