Aeumuro Gashaw Lake, M.D.

Primary specialty

Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianTaxonomy code 207VF0040X

License

MD60776447 Issued in WA

Practice address

801 Broadway Ste 707
Seattle, WA 98122-4328

Phone

(206) 386-3605

Fax

(206) 254-9220

NPI assigned

Jun 11, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: aeumuro.lake@xdr.hhchealthdirect.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Theresa a Burdick MD LLC

  • Obstetrics Physician
  • Seattle, WA
  • NPI 1982870796
  NPD (past)

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

{
    "created_epoch": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1174783427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50150",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980150150",
            "telephone_number": "425-228-5228",
            "fax_number": "425-228-5733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 BROADWAY STE 707",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981224328",
            "telephone_number": "206-386-3605",
            "fax_number": "206-254-9220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "AEUMURO",
        "middle_name": "GASHAW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-11",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WA",
            "license": "MD60776447",
            "primary": false
        },
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "WA",
            "license": "MD60776447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lake Union Counseling, LLC
• Lake Union Vision Clinic LLC
• Lake Union Wellness, PS
• Lake Union Wellness, PS
• Lake Washington Therapeutics PLLC
• Aimee Lake, DPT
• Eve Morgan Lake
• Laura Lake, A.R.N.P.
• Margaret J. Lake, LICSW
• Monica Lake, BAP

• Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician in Seattle, WA
• Providers in Seattle, WA by specialty
• Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.