| Ehpc Lakeshore | |
|
10131 Main St Bothell WA 98011-3425 | |
| (425) 485-3955 | |
| (425) 485-1476 |
| Full Name | Ehpc Lakeshore |
|---|---|
| Speciality | Family Medicine |
| Location | 10131 Main St, Bothell, Washington |
| Authorized Official Name and Position | Robert Malte (CEO) |
| Authorized Official Contact | 4258992610 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ehpc Lakeshore Po Box 35189 Seattle WA 98124-5189 Ph: (425) 485-3955 | Ehpc Lakeshore 10131 Main St Bothell WA 98011-3425 Ph: (425) 485-3955 |
| NPI Number | 1659814762 |
|---|---|
| Provider Enumeration Date | 11/21/2016 |
| Last Update Date | 11/23/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659814762 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 213E00000X | Podiatrist | (* (Not Available)) | Secondary |
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