Lake Washington Primary Care LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

33004 Issued in WA

Legal business name

LAKE WASHINGTON PRIMARY CARE LLC

Practice address

8015 SE 28TH St Ste 310
Mercer Island, WA 98040-2910

Phone

(206) 898-2416

Fax

(877) 771-1013

NPI assigned

Mar 12, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Robert Goode, MD

Title

Physician/Owner

Phone

(206) 898-2416

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1520812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520812800000",
    "number": "1902309313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8015 SE 28TH ST STE 310",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "980402910",
            "telephone_number": "206-898-2416",
            "fax_number": "877-771-1013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8015 SE 28TH ST STE 310",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "980402910",
            "telephone_number": "206-898-2416",
            "fax_number": "877-771-1013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE WASHINGTON PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-12",
        "last_updated": "2018-03-12",
        "status": "A",
        "authorized_official_last_name": "GOODE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "206-898-2416",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "33004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denise Knopp
• Christopher A Kodama, MD
• Bernice Shiu Lam Koo, RPH
• Brent Michael Krupp, MD
• Devin Marie Kubat, M.A. CCC-SLP
• Kathleen Kim Lampson Reiff, PH.D.
• Mark V Lanning, DPT
• Eric Lao, PMHNP
• Karen Whittaker Lauritzen, M.S. P.T.
• Janet Mead Leamon, LMFT

• Family Medicine Physician in Mercer Island, WA
• Providers in Mercer Island, 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 Mar 12, 2018; 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.