| Lakeside Family Physicians Pllc | |
|
390 E Sunset Way Issaquah WA 98027-3441 | |
| (425) 246-0225 | |
| (425) 395-0245 |
| Full Name | Lakeside Family Physicians Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 390 E Sunset Way, Issaquah, Washington |
| Authorized Official Name and Position | Samantha Maplethorpe (OWNER) |
| Authorized Official Contact | 4253691342 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeside Family Physicians Pllc 2623 W Pumpkin Ridge Dr Anthem AZ 85086-3027 Ph: (425) 369-1342 | Lakeside Family Physicians Pllc 390 E Sunset Way Issaquah WA 98027-3441 Ph: (425) 246-0225 |
| NPI Number | 1891902458 |
|---|---|
| Provider Enumeration Date | 05/16/2007 |
| Last Update Date | 05/30/2024 |
| Medicare PECOS PAC ID | 6002821832 |
|---|---|
| Medicare Enrollment ID | O20060215000098 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891902458 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (Washington) | Primary |
| Provider Name | Samantha Maplethorpe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396768412 PECOS PAC ID: 5496743809 Enrollment ID: I20040504001290 |
| Provider Name | David S Farrell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821173279 PECOS PAC ID: 9931252335 Enrollment ID: I20090803000385 |
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