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Organization

LAKESHORE CLINIC PLLC

Active
Other names
Lakeshore Clinic Totem Lake
Organization subpart
No

Provider details

NPI number
Authorized official
LINDA R JEPPESEN (CEO)
(425) 485-3955
Entity
Organization

Contact information

Practice address
12710 TOTEM LAKE BLVD NE, KIRKLAND, WA 98034-2907
(425) 821-4040
(425) 820-5060
Mailing address
PO BOX 646, BOTHELL, WA 98041-0646
(425) 485-3955
(425) 485-1476

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
207R00000X
Internal Medicine Physician
213E00000X
Podiatrist

Other

Enumeration date
09/14/2006
Last updated
10/11/2012
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