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Contact Information

SOUTHLAKE SELECT, PC
4011 TALBOT RD S
440
RENTON, WA98055-5773
 Phone: 425-793-4702
 Fax: 425-271-5382
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Point of Service

305S00000X
Indicates primary specialty

NPI Profile & details for SOUTHLAKE SELECT PC · (Female)

NPI # 1548791924
Status Active
Credentials
Entity Individual
Enumeration date 03/27/2017
Last updated 05/08/2017 - About 9 years ago
Sole proprietor 1 Not specified
Identifiers
  • WA License # 0020685
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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