Surprise Lake Medical Clinic | |
2748 Milton Way Ste 101 Milton WA 98354-9382 | |
(253) 922-5262 | |
(253) 922-5299 |
Full Name | Surprise Lake Medical Clinic |
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Speciality | Family Medicine |
Location | 2748 Milton Way, Milton, Washington |
Authorized Official Name and Position | Cliff Robertson (CHIEF MEDICAL OFFICER) |
Authorized Official Contact | 2537796101 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Surprise Lake Medical Clinic 2748 Milton Way Ste 101 Milton WA 98354-9382 Ph: (253) 922-5262 | Surprise Lake Medical Clinic 2748 Milton Way Ste 101 Milton WA 98354-9382 Ph: (253) 922-5262 |
NPI Number | 1962417659 |
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Provider Enumeration Date | 07/30/2006 |
Last Update Date | 06/14/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1962417659 | NPI | - | NPPES |
7124365 | Medicaid | WA | |
0105765 | Other | WA | STATE L&I |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
207R00000X | Internal Medicine | (* (Not Available)) | Secondary |