Organization Active NPI

Interlake Medical Center, PLLC

  • Family Medicine Physician
  • Redmond, WA
National Provider Identifier
1619998978
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
INTERLAKE MEDICAL CENTER, PLLC
Practice address
2103 152ND Ave NE
Redmond, WA 98052-5520
Phone
(425) 746-2400
Fax
(425) 746-2659
NPI assigned
Jul 22, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Norman H. Leou, M.D.
Title
Managing Director
Phone
(425) 746-2400

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X

Addresses

Primary practice location

2103 152ND Ave NE
Redmond, WA 98052-5520

Mailing address

2103 152ND Ave NE
Redmond, WA 98052-5520
Phone (425) 746-2400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040401000406 WA Part B Supplier - Clinic/Group Practice 0446242242 Receives reassigned benefits from 4 practitioners
Practice locations: Redmond, WA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D0630705Interlake Medical Center2103 152ND NE, Redmond, WA 98052Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory

Locations

2103 152nd Ave NE
Redmond, WA 98052
Phone (206) 746-2400

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1619998978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2103 152ND AVE NE",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980525520",
            "telephone_number": "425-746-2400",
            "fax_number": "425-746-2659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 152ND AVE NE",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980525520",
            "telephone_number": "425-746-2400",
            "fax_number": "425-746-2659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERLAKE MEDICAL CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "LEOU",
        "authorized_official_first_name": "NORMAN",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "425-746-2400",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.