| The Lakewood Clinic | |
|
11311 Bridgeport Way Sw Ste 100 Lakewood WA 98499-3071 | |
| (253) 581-6688 | |
| (253) 512-2894 |
| Full Name | The Lakewood Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 11311 Bridgeport Way Sw, Lakewood, 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 |
|---|---|
| The Lakewood Clinic 11311 Bridgeport Way Sw Ste 100 Lakewood WA 98499-3071 Ph: (253) 581-6688 | The Lakewood Clinic 11311 Bridgeport Way Sw Ste 100 Lakewood WA 98499-3071 Ph: (253) 581-6688 |
| NPI Number | 1093723439 |
|---|---|
| Provider Enumeration Date | 08/03/2006 |
| Last Update Date | 06/20/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093723439 | NPI | - | NPPES |
| 0193323 | Other | WA | STATE L&I |
| 7125057 | Medicaid | WA | |
| 7130685 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
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