Individual
MR. NATHAN O LAKE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
700 NW GILMAN BLVD, E103/352, ISSAQUAH, WA 98027-5395
(425) 269-6466
Mailing address
700 NW GILMAN BLVD, E103/352, ISSAQUAH, WA 98027-5395
(425) 269-6466
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0001118197
VA
Other
Enumeration date
05/27/2005
Last updated
07/08/2007
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