NPI 1104962331
Southlake Clinic INC., P.S.
Practice location
- Address
- 4011 Talbot Rd S Suite 500, Renton, WA 98055-5773
- Phone
- (425) 251-5110
- Fax
- (425) 793-4707
- Mailing address
- PO Box 59028, Renton, WA 98058-2028
Authorised official
- Name
- James Dwight Hudson
- Title
- Coo
- Phone
- (425) 793-4725
Registered specialties (15)
Internal Medicine Physician
Primary
Dermatology Physician
Cardiovascular Disease Physician
Critical Care Medicine (Internal Medicine) Physician
Endocrinology, Diabetes & Metabolism Physician
Gastroenterology Physician
Hematology & Oncology Physician
Interventional Cardiology Physician
Infectious Disease Physician
Pulmonary Disease Physician
Sleep Medicine (Internal Medicine) Physician
Nuclear Cardiology Physician
Hospitalist Physician
Physician Assistant
Nurse Practitioner
Registry record
- NPI
- 1104962331
- Entity type
- Organization
- NPI issued
- 29 Jan 2007
- Record last updated
- 13 Jul 2017
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.