| Totem Lake Pediatrics | |
|
13128 Totem Lake Blvd Ne Ste 105 Kirkland WA 98034-2953 | |
| (425) 899-4570 | |
| Not Available |
| Full Name | Totem Lake Pediatrics |
|---|---|
| Speciality | Clinic/center |
| Location | 13128 Totem Lake Blvd Ne Ste 105, Kirkland, Washington |
| Authorized Official Name and Position | Firoz Ibrahim (OWNER) |
| Authorized Official Contact | 4258994570 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Totem Lake Pediatrics 13128 Totem Lake Blvd Ne Ste 105 Kirkland WA 98034-2953 Ph: (425) 899-4570 | Totem Lake Pediatrics 13128 Totem Lake Blvd Ne Ste 105 Kirkland WA 98034-2953 Ph: (425) 899-4570 |
| NPI Number | 1376706028 |
|---|---|
| Provider Enumeration Date | 07/02/2008 |
| Last Update Date | 07/02/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376706028 | NPI | - | NPPES |
| 1078922 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | MD00029356 (Washington) | Primary |
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