| NPI | 1164021077 |
|---|---|
| Doing Business As | GREENLAKE DPC |
| Entity Type | Organization |
| Authorized Contact | NAOMI BUSCH Managing Member 206-914-6116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2020-10-21 |
| Last Update Date | 2020-10-21 |