institution
Southlake Clinic Inc Ps
Endoscopy Clinic/Center in Renton, Washington
NPI 1043368426

Southlake Clinic Inc Ps is a Endoscopy Clinic/Center based in Renton, WA and is specialized in Endoscopy. Southlake Clinic Inc Ps practices in Renton, WA. The NPI Number for Southlake Clinic Inc Ps is 1043368426 and holds a License No. FS.60293976 (Washington).

The current practice location address for Southlake Clinic Inc Ps is 4011 Talbot Road South, Renton, WA and can be reached out via phone at 425-251-5110 and via fax at 425-793-4710.

Location: 4011 Talbot Road South, Renton, WA, 98058-2028
institution
Provider Profile Details
NPI Number
1043368426
Provider Name
Southlake Clinic Inc Ps
Credential
Provider Entity Type
Organization
Address
4011 Talbot Road South, Renton, WA, 98058-2028
Phone Number
425-251-5110
Fax Number
425-793-4710
Provider Enumeration Date
01/08/2007
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
490003337 01 WA RAILROAD MEDICARE
0119463 01 WA L&I
7083660 05 WA
institution
Provider Business Practice Location Address Details
Address
4011 Talbot Road South
City
State
Zip
98055
Phone Number
425-251-5110
Fax Number
425-793-4710
person
Provider Business Mailing Address Details
Address
4011 Talbot Road South
City
State
Zip
98055
Phone Number
425-251-5110
Fax Number
425-793-4710
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Ambulatory Surgical
Taxonomy
License No.
FS.60293976 (Washington)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Endoscopy
Taxonomy
License No.
FS.60293976 (Washington)
Definition
Definition to come...
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