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Organization
CREEKSIDE SLEEP MEDICINE CENTER PLLC
Active
Organization
CREEKSIDE SLEEP MEDICINE CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERESA E. JACOBS M.D. (MEDICAL DIRECTOR)
(425) 278-2250
Entity
Organization
Contact information
Practice address
1380 112TH AVE NE, #307, BELLEVUE, WA 98004-3759
(425) 278-2250
(425) 562-5885
Mailing address
1380 112TH AVE NE, #307, BELLEVUE, WA 98004-3759
(425) 278-2250
(425) 562-5885
Taxonomy
Speciality
Code
Description
License number
State
207QS1201X
Sleep Medicine (Family Medicine) Physician
Primary
—
WA
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
602620178
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
602620178
UBI
WA
Enumeration date
04/19/2007
Last updated
12/13/2012
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