| Lake Forest Park Medical Clinic | |
|
17191 Bothell Way Ne Lake Forest Park WA 98155-5534 | |
| (206) 365-6768 | |
| (206) 364-5418 |
| Full Name | Lake Forest Park Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 17191 Bothell Way Ne, Lake Forest Park, Washington |
| Authorized Official Name and Position | Charles William Schneider (PRES/CEO) |
| Authorized Official Contact | 2063681700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Forest Park Medical Clinic 17191 Bothell Way Ne Suite 205 Lake Forest Park WA 98155-5534 Ph: (206) 365-6768 | Lake Forest Park Medical Clinic 17191 Bothell Way Ne Lake Forest Park WA 98155-5534 Ph: (206) 365-6768 |
| NPI Number | 1548222102 |
|---|---|
| Provider Enumeration Date | 04/06/2006 |
| Last Update Date | 04/21/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548222102 | NPI | - | NPPES |
| CJ6346 | Other | WA | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Evolve Md, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 19243 Forest Park Dr Ne, Lake Forest Park, WA 98155 Phone: 206-518-2122 |