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

Southlake Clinic Inc Ps

Organization Anatomic Pathology Physician · NPI 1538394234

Southlake Clinic Inc Ps is an Anatomic Pathology Physician in Renton, Washington. Licensed in Washington. Registered with an NPI since 2009.

Licensed in
WA
In the registry since
2009
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 98055-5773
Phone: (425) 251-5110
Fax: (425) 793-4710
Show map & directions

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

Specialties & licences

Anatomic Pathology Physician (primary) Taxonomy 207ZP0101X · Licence MD00015542 (WA)

Record details

NPI number1538394234
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Marianne Larson — Coo · (425) 251-5110
Other names Southlake Clinic Pathology
NPI enumeratedMay 26, 2009
Last updated in NPPESAugust 6, 2012
Mailing addressPo Box 59028, Renton, WA 98058-2028