Totem Lake Family Medicine, PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

BUS14337 Issued in WA

Legal business name

TOTEM LAKE FAMILY MEDICINE, PLLC

Practice address

11800 NE 128TH St
Ste, 560
Kirkland, WA 98034-7208

Phone

(425) 899-5200

Fax

(425) 285-3108

NPI assigned

Jun 28, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Dale Y. Miyauchi, M.D.

Title

Partner

Phone

(425) 899-5200

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336694400000",
    "number": "1023215514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11800 NE 128TH ST",
            "address_2": "STE. 560",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980347208",
            "telephone_number": "425-899-5200",
            "fax_number": "425-285-3108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11800 NE 128TH ST",
            "address_2": "STE, 560",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980347208",
            "telephone_number": "425-899-5200",
            "fax_number": "425-285-3108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTEM LAKE FAMILY MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-28",
        "last_updated": "2012-05-11",
        "status": "A",
        "authorized_official_last_name": "MIYAUCHI",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "Y.",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "425-899-5200",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "BUS14337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• K Melissa Tomlin
• Amy Tong
• Annie Tookey, LMFT
• Lenin Torres
• Michelle Toshika Toshima, PHD
• Totem Lake Pediatrics
• Tough Monkey, LLC
• Melina Marie Tovar, LMFTA
• Vicky Tovar, OT
• Michael A Towbin, M.D.

• Family Medicine Physician in Kirkland, WA
• Providers in Kirkland, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.