Southlake Select, PC
Southlake Select, PC is an Internal Medicine Physician in Renton, Washington. Licensed in Washington. Registered with an NPI since 2017.
- Licensed in
- WA
- In the registry since
- 2017
- Specialties on file
- 2
What do these letters mean?
- PC — Professional corporation
- A form of business registration, not a clinical qualification.
Practice location Address checks out
4011 Talbot Rd S 440Renton, WA 98055-5773
Phone: (425) 793-4702
Fax: (425) 271-5382
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Internal Medicine Physician (primary) | Taxonomy 207R00000X |
|---|---|
| Point of Service | Taxonomy 305S00000X · Licence 0020685 (WA) |
Record details
| NPI number | 1548791924 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Dominick Toulouse — President · (425) 793-4702 |
| NPI enumerated | March 27, 2017 |
| Last updated in NPPES | May 8, 2017 |
| Mailing address | 4011 Talbot Rd S, 440, Renton, WA 98055-5773 |
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