Lake Tye Emergency Physicians Pllc

NPI #1467880518 in Monroe, Washington

Provider Information

NPI Number: 1467880518
Entity Type: Organization
Organization Name: Lake Tye Emergency Physicians Pllc
Primary Specialty: Emergency Medicine
Enumeration Date: Oct 29, 2013
Last Updated: Oct 29, 2013

Practice Location

Address: 14701 179TH AVE SE
City: Monroe
State: Washington
ZIP Code: 98272-1108
Phone: (360) 794-7497

Authorized Official

Name: CHARLES MITCHELL, MD
Title: PRESIDENT
Phone: (469) 401-2386

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X
Nurse Practitioner	363L00000X
Emergency Medicine	207P00000X	Primary

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