Lakeshore Clinic Pllc

NPI #1922052422 in Bothell, Washington

Provider Information

NPI Number: 1922052422
Entity Type: Organization
Organization Name: Lakeshore Clinic Pllc
Primary Specialty: Family Medicine
Enumeration Date: May 19, 2006
Last Updated: Feb 18, 2014

Practice Location

Address: 10131 MAIN ST
City: Bothell
State: Washington
ZIP Code: 98011-3425
Phone: (425) 485-3955

Authorized Official

Name: LINDA R JEPPESEN
Title: CEO
Phone: (425) 485-3955

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X
Podiatrist	213E00000X
Family Medicine	207Q00000X	Primary

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