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Lake Wilderness Medical Clinic Llc
Medical Specialty Clinic/Center in Maple Valley, Washington
NPI 1669647152

Lake Wilderness Medical Clinic Llc is a Medical Specialty Clinic/Center based in Ravensdale, WA and is specialized in Medical Specialty. Lake Wilderness Medical Clinic Llc practices in Maple Valley, WA. The NPI Number for Lake Wilderness Medical Clinic Llc is 1669647152 and holds a License No. 602777613 (Washington).

The current practice location address for Lake Wilderness Medical Clinic Llc is 26907 Maple Valley Black Diamond Rd Se, Maple Valley, WA and can be reached out via phone at 425-432-9611 and via fax at 206-973-5399.

Location: 26907 Maple Valley Black Diamond Rd Se, Maple Valley, WA, 98051-1142
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1669647152
Provider Name
Lake Wilderness Medical Clinic Llc
Credential
Provider Entity Type
Organization
Address
26907 Maple Valley Black Diamond Rd Se, Maple Valley, WA, 98051-1142
Phone Number
425-432-9611
Fax Number
206-973-5399
Provider Enumeration Date
04/25/2008
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
26907 Maple Valley Black Diamond Rd Se
City
Maple Valley
State
Washington
Zip
98038-8314
Phone Number
425-432-9611
Fax Number
206-973-5399
person
Provider Business Mailing Address Details
Address
26907 Maple Valley Black Diamond Rd Se
City
Maple Valley
State
Washington
Zip
98038-8314
Phone Number
425-432-9611
Fax Number
206-973-5399
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Medical Specialty
Taxonomy
261QM2500X
License No.
602777613 (Washington)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
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