Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lakeshore Clinic PLLC

Organization Family Medicine Physician · NPI 1922052422

Lakeshore Clinic PLLC is a Family Medicine Physician in Bothell, Washington. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
3
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

10131 Main St
Bothell, WA 98011-3425
Phone: (425) 485-3955
Fax: (425) 485-1476
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Internal Medicine Physician Taxonomy 207R00000X
Podiatrist Taxonomy 213E00000X

Record details

NPI number1922052422
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Linda Jeppesen — Ceo · (425) 485-3955
NPI enumeratedMay 19, 2006
Last updated in NPPESFebruary 18, 2014
Mailing addressPo Box 646, Bothell, WA 98041-0646

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