Southlake Clinic Inc., P.s. is a Nurse Practitioner based in Renton, WA. Southlake Clinic Inc., P.s. practices in Renton, WA. The NPI Number for Southlake Clinic Inc., P.s. is 1104962331 and holds a License No. (Washington).
The current practice location address for Southlake Clinic Inc., P.s. is 4011 Talbot Rd S, Renton, WA and can be reached out via phone at 425-251-5110 and via fax at 425-793-4707. You can also correspond with Southlake Clinic Inc., P.s. through the mailing address at PO BOX 59028, RENTON, WA - 98058-2028 (mailing address contact number: 425-251-5110).
Location: 4011 Talbot Rd S, Renton, WA, 98058-2028
Provider Profile Details
NPI Number
1104962331
Provider Name
Southlake Clinic Inc., P.s.
Credential
Provider Entity Type
Organization
Address
4011 Talbot Rd S, Renton, WA, 98058-2028
Phone Number
425-251-5110
Fax Number
425-793-4707
Provider Enumeration Date
01/29/2007
Last Update Date
03/12/2024
Provider's Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7072440 | 05 | WA | |
| CS3809 | 01 | WA | RR MEDICARE |
| 0057600 | 01 | WA | L&I |
Provider Business Practice Location Address Details
Address
4011 Talbot Rd S
City
State
Zip
98055-5773
Phone Number
425-251-5110
Fax Number
425-793-4707
Provider Business Mailing Address Details
Address
Po Box 59028
City
State
Zip
98058-2028
Phone Number
425-251-5110
Fax Number
425-277-1301
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Dermatology
Speciality
-
Taxonomy
License No.
()
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Internal Medicine
Speciality
-
Taxonomy
License No.
()
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Provider's Taxonomy Details 3
Type
Allopathic & Osteopathic Physicians
Classification
Internal Medicine
Speciality
Cardiovascular Disease
Taxonomy
License No.
()
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Provider's Taxonomy Details 4
Type
Allopathic & Osteopathic Physicians
Classification
Internal Medicine
Speciality
Critical Care Medicine
Taxonomy
License No.
()
Definition
An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.
Provider's Taxonomy Details 5
Type
Allopathic & Osteopathic Physicians
Classification
Internal Medicine
Speciality
Endocrinology, Diabetes & Metabolism
Taxonomy
License No.
()
Definition
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.
Provider's Taxonomy Details 6
Type
Allopathic & Osteopathic Physicians
Classification
Internal Medicine
Speciality
Gastroenterology
Taxonomy
License No.
()
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
Provider's Taxonomy Details 7
Type
Allopathic & Osteopathic Physicians
Classification
Internal Medicine
Speciality
Hematology & Oncology
Taxonomy
License No.
()
Definition
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.
Provider's Taxonomy Details 8
Type
Allopathic & Osteopathic Physicians
Classification
Internal Medicine
Speciality
Interventional Cardiology
Taxonomy
License No.
()
Definition
An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system.
Provider's Taxonomy Details 9
Type
Allopathic & Osteopathic Physicians
Classification
Internal Medicine
Speciality
Infectious Disease
Taxonomy
License No.
()
Definition
An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine.
Provider's Taxonomy Details 10
Type
Allopathic & Osteopathic Physicians
Classification
Internal Medicine
Speciality
Pulmonary Disease
Taxonomy
License No.
()
Definition
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
Provider's Taxonomy Details 11
Type
Allopathic & Osteopathic Physicians
Classification
Internal Medicine
Speciality
Sleep Medicine
Taxonomy
License No.
()
Definition
An Internist who practices Sleep Medicine is certified in the subspecialty of sleep medicine and specializes in the clinical assessment, physiologic testing, diagnosis, management and prevention of sleep and circadian rhythm disorders. Sleep specialists treat patients of any age and use multidisciplinary approaches. Disorders managed by sleep specialists include, but are not limited to, sleep related breathing disorders, insomnia, hypersomnias, circadian rhythm sleep disorders, parasomnias and sleep related movement disorders.
Provider's Taxonomy Details 12
Type
Allopathic & Osteopathic Physicians
Classification
Nuclear Medicine
Speciality
Nuclear Cardiology
Taxonomy
License No.
()
Definition
A nuclear medicine physician who specializes in nuclear cardiology.
Provider's Taxonomy Details 13
Type
Allopathic & Osteopathic Physicians
Classification
Hospitalist
Speciality
-
Taxonomy
License No.
()
Definition
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.
Provider's Taxonomy Details 14
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
-
Taxonomy
License No.
()
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Provider's Taxonomy Details 15
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
-
Taxonomy
License No.
()
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
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