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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

LAKE WILDERNESS MEDICAL CLINIC LLC

Active Organization

LAKE WILDERNESS MEDICAL CLINIC LLC is a Exclusive Provider Organization organization located in MAPLE VALLEY, Washington. NPI 1982879045 is currently active in the NPPES registry. Verify at CMS.

Exclusive Provider Organization · MAPLE VALLEY, WA

Registration Details

NPI Number
1982879045
Provider Type
Organization
NPI Issued
Apr 29, 2008 (18.312466611285 yrs)
Last Updated
Apr 29, 2008
License
MD00023662 (WA)

Practice Information

Address
26907 MAPLE VALLEY BLACK DIAMOND RD SE
MAPLE VALLEY, WA, 980388314
Browse WA providers · Browse ZIP 98038
Phone
4254329611
Fax
2069735399
Primary Specialty
Exclusive Provider Organization
302F00000X
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.