SOUTHLAKE CLINIC INC., P.S.

RENTON, WA
NPI1104962331
Former Legal Business NameVALLEY INTERNAL MEDICINE INC PS
Entity TypeOrganization
Authorized ContactJAMES DWIGHT HUDSON
COO
425-793-4725
Organization Subpart ?No
Primary Taxonomy207R00000X Internal Medicine
Additional Taxonomies207N00000X Dermatology
207RC0000X Internal Medicine, Cardiovascular Disease
207RC0200X Internal Medicine, Critical Care Medicine
207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism
207RG0100X Internal Medicine, Gastroenterology
207RH0003X Internal Medicine, Hematology & Oncology
207RI0011X Internal Medicine, Interventional Cardiology
207RI0200X Internal Medicine, Infectious Disease
207RP1001X Internal Medicine, Pulmonary Disease
207RS0012X Internal Medicine, Sleep Medicine
207UN0901X Nuclear Medicine, Nuclear Cardiology
208M00000X Hospitalist
363A00000X Physician Assistant
363L00000X Nurse Practitioner
Enumeration Date2007-01-29
Last Update Date2017-07-13
Business Address
SOUTHLAKE CLINIC INC., P.S.
4011 TALBOT RD S SUITE 500
RENTON, WA 98055-5773
Phone number: 425-251-5110
Mailing Address
SOUTHLAKE CLINIC INC., P.S.
PO BOX 59028
RENTON, WA 98058-2028
Phone number: 425-251-5110