LAKESIDE FAMILY PHYSICIANS (NPI# 1891902458) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891902458 |
| Entity Type | Organization |
| Organization Name | LAKESIDE FAMILY PHYSICIANS |
| Practice Address |
3707 Providence Point Dr Se Ste G Issaquah WA 98029-6216 |
| Practice Telephone | 4253691342 |
| Practice Fax Number | 4253950245 |
| Mailing Telephone | 4253691342 |
| Mailing Fax Number | 4253950245 |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MICHELLE TEEL (OFFICE MANAGER) |
| Authorized Official Telephone | 4253691342 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
WA | Ambulatory Health Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | LAKESIDE FAMILY PHYSICIANS, PLLC | 390 E Sunset Way, Issaquah, WA 98027-3441 |
| Street Address |
3707 PROVIDENCE POINT DR SE STE G |
| City | ISSAQUAH |
| State | WA |
| Zip Code | 98029-6216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396768412 | Samantha Marie Maplethorpe | Family Medicine | 3707 Providence Point Dr Se Ste G, Issaquah, WA 98029-6216 | 2006-07-26 |
| 1861794604 | Molly Mullen | Nurse Practitioner | 3707 Providence Point Dr Se Ste G, Issaquah, WA 98029-6216 | 2010-11-30 |
| 1083637110 | Jennifer Spence | Family Medicine | 3707 Providence Point Dr Se Ste G, Issaquah, WA 98029-6216 | 2006-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134730161 | Katelyn Creech | Counselor | 1505 16th Lane Ne, Apt 404 Building O, Issaquah, WA 98029 | 2020-08-13 |
| 1326695438 | M Shoaib Haider Siddiqui | Dentist | Issaquah Modern Dentistry, 1416 Highlands Drie Ne, Suite 120, Issaquah, WA 98029 | 2019-08-22 |
| 1053885061 | Rose Osborne | Registered Nurse | 4580 Klahanie Dr Se #181, Sammamish, WA 98029 | 2019-01-14 |
| 1598260960 | Caryn Crosbie | Behavior Technician | 22526 Se 64th Place, Building D Suite 210, Issaquah, WA 98029 | 2018-03-28 |
| 1194110908 | May Y. Mar | Family Medicine | 5708 E. Lake Sammamish Pkwy Se, Issaquah, WA 98029 | 2015-03-30 |
| 1659765816 | Eastside Social Skills Therapy LLC | Preferred Provider Organization | 5436 232nd Ave Se, Issaquah, WA 98029 | 2015-03-26 |
| 1649513946 | Linda Scoppettone Knodel | Registered Nurse | 5303 231 Ave. Se, Issaquah, WA 98029 | 2013-04-04 |
| 1720323116 | Morley Slutsky | Preventive Medicine | 4580 Klahanie Dr. S.e.,#125, Issaquah, WA 98029 | 2012-12-11 |
| 1619248820 | Silas Dickenson Dudley | Dentist | 2520 Ne Park Dr, Suite C, Issaquah, WA 98029 | 2012-01-19 |
| 1659641678 | Cynthia J Creel | Technician/Technologist | 4580 Klahanie Dr. Se, #332, Issaquah, WA 98029 | 2012-01-06 |
| Find all providers in zip 98029 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720426372 | Village Pediatrics, Pllc | Clinic/Center | 317 Nw Gilman Blvd Ste 48, Issaquah, WA 98027-2485 | 2013-06-05 |
| 1851549034 | Village Family Clinic and Wellness Center, Pllc | Clinic/Center | 317 Nw Gilman Blvd, Suite 48, Issaquah, WA 98027-2496 | 2008-08-31 |
| 1699811786 | Lcrasmussen, Do, P.s.c. | Clinic/Center | 19129 Se 63rd Pl, Issaquah, WA 98027-8621 | 2007-01-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992315808 | Vera Whole Health Wa, PC | Clinic/Center | 6700 Fort Dent Way Ste 100, Tukwila, WA 98188-2500 | 2020-08-05 |
| 1063037034 | Pioneer Family Medicine, Pllc | Clinic/Center | 20 E J St Ste 2b, Deer Park, WA 99006-8500 | 2020-06-15 |
| 1922622158 | Vera Whole Health Wa, PC | Clinic/Center | 16009 E Indiana Ave, Spokane Valley, WA 99216 | 2020-06-03 |
| 1578183729 | Family Care Network Pllc | Clinic/Center | 3548 Meridian St, Suite #101-b, Bellingham, WA 98225 | 2020-04-17 |
| 1548800451 | Vera Whole Health Wa PC | Clinic/Center | 1601 N Division St, Spokane, WA 99207-2427 | 2020-01-08 |
| 1821634312 | Columbia Basin Mobile Medicine LLC | Clinic/Center | 1357 Platinum Pl, West Richland, WA 99353-5108 | 2019-11-20 |
| 1063056497 | A Community Wellness Clinic LLC | Clinic/Center | 2405 E 17th Ave Ste 113, Spokane, WA 99223-5122 | 2019-10-29 |
| 1013550987 | Rejuventa Medical Corp. | Clinic/Center | 107 North Tower Ave Suite 17, Centralia, WA 98531-4253 | 2019-10-23 |
| 1023668407 | Vera Whole Health Wa, PC | Clinic/Center | 4933 Evergreen Way, Everett, WA 98203-2828 | 2019-09-17 |
| 1679042501 | Family and Wellness Medicine | Clinic/Center | 34004 16th Ave S Ste 100, Federal Way, WA 98003-8905 | 2018-11-20 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.