Organization
LAKE WASHINGTON VASCULAR PLLC
Active
Organization
LAKE WASHINGTON VASCULAR PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL PEPPER MD (MANAGING PARTNER, PLLC)
(425) 453-1772
Entity
Organization
Contact information
Practice address
1135 116TH AVE NE STE 305, BELLEVUE, WA 98004-4623
(425) 453-1772
(425) 453-0603
Mailing address
PO BOX 94732, SEATTLE, WA 98124-7032
(425) 453-1772
(425) 453-0603
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7105083
—
WA
01
—
CH9340
RR MEDICARE
WA
Enumeration date
08/17/2005
Last updated
02/25/2015
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