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Organization
LAKE FOREST PARK CLINIC TR
Active
Organization
LAKE FOREST PARK CLINIC TR
Active
Other names
Lake Forest Park Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHARLES WILLIAM SCHNEIDER (PRES/CEO)
(206) 368-1700
Entity
Organization
Contact information
Practice address
17191 BOTHELL WAY NE, LAKE FOREST PARK, WA 98155-5534
(206) 365-6768
(206) 364-5418
Mailing address
17191 BOTHELL WAY NE, SUITE 205, LAKE FOREST PARK, WA 98155-5534
(206) 365-6768
(206) 364-5418
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
04/06/2006
Last updated
04/21/2011
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