NPIMap

Organization Active NPI

Lakes Family Medicine, PS

  • Clinic/Center
  • Puyallup, WA
National Provider Identifier
1386754661
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
MD0037764 Issued in WA
Legal business name
LAKES FAMILY MEDICINE, PS
Practice address
10116 116TH St E
Suite 101
Puyallup, WA 98373-3543
Phone
(253) 864-0224
Fax
(253) 864-0634
NPI assigned
Aug 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Linh T Huynh, MDNPI 1508881228
Title
Owner
Phone
(253) 864-0224

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X MD0037764 WA Primary

Addresses

Primary practice location

10116 116TH St E
Suite 101
Puyallup, WA 98373-3543

Mailing address

10116 116TH St E
Suite 101
Puyallup, WA 98373-3543
Phone (253) 864-0224

Other identifiers 2

IdentifierTypeStateIssuer
8250888MedicaidWA
8251944MedicaidWA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386754661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10116 116TH ST E",
            "address_2": "SUITE 101",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983733543",
            "telephone_number": "253-864-0224",
            "fax_number": "253-864-0634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10116 116TH ST E",
            "address_2": "SUITE 101",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983733543",
            "telephone_number": "253-864-0224",
            "fax_number": "253-864-0634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKES FAMILY MEDICINE, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HUYNH",
        "authorized_official_first_name": "LINH",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-864-0224",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WA",
            "license": "MD0037764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8250888",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8251944",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.