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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