SOUTHLAKE CLINIC INC PS

RENTON, WA
NPI1548319171
Former Legal Business NameVALLEY INTERNAL MEDICINE INC PS
Entity TypeOrganization
Authorized ContactMARIANNE LARSON
Chief Operations Officer
425-251-5110
Organization Subpart ?Yes
Primary Taxonomy291U00000X Clinical Medical Laboratory
(Licence: WA  600052154)
Enumeration Date2007-01-10
Last Update Date2010-03-03
Business Address
SOUTHLAKE CLINIC INC PS
3915 TALBOT ROAD SOUTH SUITE 300
RENTON, WA 98055
Phone number: 425-251-5110
Mailing Address
SOUTHLAKE CLINIC INC PS
PO BOX 59028
RENTON, WA 98058-2028
Phone number: 425-251-5110