Organization
TOTEM LAKE PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FIROZ IBRAHIM (OWNER)
(425) 899-4570
Entity
Organization
Contact information
Practice address
13128 TOTEM LAKE BLVD NE STE 105, KIRKLAND, WA 98034-2953
(425) 899-4570
Mailing address
13128 TOTEM LAKE BLVD NE STE 105, KIRKLAND, WA 98034-2953
(425) 899-4570
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
MD00029356
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1078922
—
WA
Enumeration date
07/02/2008
Last updated
07/02/2008
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