Organization · Type 2 NPI

Southlake Clinic Inc., P.s.

Internal Medicine Physician · Renton, WA

NPI number 1104962331 Active

Practice location

4011 Talbot Rd S, Suite 500
Renton, WA 98055-5773

Fax (425) 793-4707

Mailing address

PO Box 59028
Renton, WA 98058-2028

Specialties and licenses

TaxonomyCodeLicense
Dermatology Physician 207N00000XNone listed
Internal Medicine Physician Primary 207R00000XNone listed
Cardiovascular Disease Physician 207RC0000XNone listed
Critical Care Medicine (Internal Medicine) Physician 207RC0200XNone listed
Endocrinology, Diabetes & Metabolism Physician 207RE0101XNone listed
Gastroenterology Physician 207RG0100XNone listed
Hematology & Oncology Physician 207RH0003XNone listed
Interventional Cardiology Physician 207RI0011XNone listed
Infectious Disease Physician 207RI0200XNone listed
Pulmonary Disease Physician 207RP1001XNone listed
Sleep Medicine (Internal Medicine) Physician 207RS0012XNone listed
Nuclear Cardiology Physician 207UN0901XNone listed
Hospitalist Physician 208M00000XNone listed
Physician Assistant 363A00000XNone listed
Nurse Practitioner 363L00000XNone listed

Internal Medicine Physician: A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medi…

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About NPI 1104962331

Southlake Clinic Inc., P.s.'s National Provider Identifier is 1104962331, issued on Jan 29, 2007. The primary taxonomy on file is Internal Medicine Physician (207R00000X), and the practice location is in Renton, WA. The record was last updated on Jul 13, 2017.