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

Southlake Clinic Inc Ps

Organization Ambulatory Surgical Clinic/Center · NPI 1043368426

Southlake Clinic Inc Ps is an Ambulatory Surgical Clinic/Center in Renton, Washington. Licensed in Washington. Registered with an NPI since 2007.

Licensed in
WA
In the registry since
2007
Specialties on file
2
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4011 Talbot Rd S Ste 500
Renton, WA 98055
Phone: (425) 251-5110
Fax: (425) 793-4710
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Ambulatory Surgical Clinic/Center (primary) Taxonomy 261QA1903X · Licence FS.60293976 (WA)
Endoscopy Clinic/Center Taxonomy 261QE0800X · Licence FS.60293976 (WA)

Record details

NPI number1043368426
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Marianne Larson — Director Of Operations · (425) 251-5110
NPI enumeratedJanuary 8, 2007
Last updated in NPPESNovember 20, 2012
Mailing addressPo Box 59028, Renton, WA 98058-2028

Other providers in Renton