1982879045 LAKE WILDERNESS MEDICAL CLINIC LLC

Exclusive Provider Organization

Active

Basic Information

Organization Name
LAKE WILDERNESS MEDICAL CLINIC LLC
Enumeration Date
April 29, 2008
Last Update
April 29, 2008
Authorized Official
CHESTER E JANGALA JR. MD
PHYSICIAN
Phone: (425) 432-9611

Practice Location

Address
26907 MAPLE VALLEY BLACK DIAMOND RD SE
MAPLE VALLEY, WA 980388314
Phone
(425) 432-9611
Fax
(206) 973-5399

Mailing Address

Address
PO BOX 1142
RAVENSDALE, WA 980511142
Phone
(425) 432-9611
Fax
(206) 973-5399

Specialties & Taxonomies

Specialty Code Classification License State Primary
Exclusive Provider Organization
 302F00000X Exclusive Provider Organization MD00023662 WA Primary

Frequently Asked Questions

What is LAKE WILDERNESS MEDICAL CLINIC LLC's NPI number?
LAKE WILDERNESS MEDICAL CLINIC LLC's NPI number is 1982879045.
Which doctor has NPI number 1982879045?
The doctor with NPI number 1982879045 is LAKE WILDERNESS MEDICAL CLINIC LLC.
What is LAKE WILDERNESS MEDICAL CLINIC LLC's practice address?
LAKE WILDERNESS MEDICAL CLINIC LLC's practice address is 26907 MAPLE VALLEY BLACK DIAMOND RD SE, MAPLE VALLEY, WA, 980388314.
Which doctor practices at 26907 MAPLE VALLEY BLACK DIAMOND RD SE, MAPLE VALLEY, WA, 980388314?
LAKE WILDERNESS MEDICAL CLINIC LLC practices at 26907 MAPLE VALLEY BLACK DIAMOND RD SE, MAPLE VALLEY, WA, 980388314.
What is LAKE WILDERNESS MEDICAL CLINIC LLC's mailing address?
LAKE WILDERNESS MEDICAL CLINIC LLC's mailing address is PO BOX 1142, RAVENSDALE, WA, 980511142.
What is LAKE WILDERNESS MEDICAL CLINIC LLC's phone number?
LAKE WILDERNESS MEDICAL CLINIC LLC's phone number is (425) 432-9611.
Who is (425) 432-9611?
(425) 432-9611 is the phone number for LAKE WILDERNESS MEDICAL CLINIC LLC.
What is LAKE WILDERNESS MEDICAL CLINIC LLC's specialty?
LAKE WILDERNESS MEDICAL CLINIC LLC's specialty is Exclusive Provider Organization.
What type of doctor is LAKE WILDERNESS MEDICAL CLINIC LLC?
LAKE WILDERNESS MEDICAL CLINIC LLC is a Exclusive Provider Organization.
Is LAKE WILDERNESS MEDICAL CLINIC LLC a Exclusive Provider Organization?
Yes, LAKE WILDERNESS MEDICAL CLINIC LLC is a Exclusive Provider Organization.
Is LAKE WILDERNESS MEDICAL CLINIC LLC still practicing?
Yes, LAKE WILDERNESS MEDICAL CLINIC LLC is currently practicing.
Is LAKE WILDERNESS MEDICAL CLINIC LLC accepting new patients?
LAKE WILDERNESS MEDICAL CLINIC LLC may be accepting new patients. Please call their office at (425) 432-9611 to inquire about availability.
Is NPI 1982879045 still active?
Yes, NPI 1982879045 is currently active.
Where does LAKE WILDERNESS MEDICAL CLINIC LLC practice?
LAKE WILDERNESS MEDICAL CLINIC LLC practices in MAPLE VALLEY, WA.