| Lakes Family Medicine-puyallup | |
|
10116 116th St E Ste 101 Puyallup WA 98373-3543 | |
| (253) 864-0224 | |
| (253) 864-0634 |
| Full Name | Lakes Family Medicine-puyallup |
|---|---|
| Speciality | Family Medicine |
| Location | 10116 116th St E, Puyallup, Washington |
| Authorized Official Name and Position | Cliff A. Robertson (PRESIDENT/ CHIEF MEDICAL OFFICER) |
| Authorized Official Contact | 2537796101 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakes Family Medicine-puyallup 10116 116th St E Ste 101 Puyallup WA 98373-3543 Ph: (253) 864-0224 | Lakes Family Medicine-puyallup 10116 116th St E Ste 101 Puyallup WA 98373-3543 Ph: (253) 864-0224 |
| NPI Number | 1871786483 |
|---|---|
| Provider Enumeration Date | 08/27/2007 |
| Last Update Date | 02/20/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871786483 | NPI | - | NPPES |
| 0224333 | Other | WA | STATE L&I |
| 7139173 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Washington) | Primary |
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