MEDICARE: MR. NATHAN O LAKE RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	0001118197	VA

General Provider Information

NPI Number	:	1447253059
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. NATHAN O LAKE RN

Provider Business Mailing Address
First Line	:	700 NW GILMAN BLVD
Second Line	:	E103/352
City	:	ISSAQUAH
State	:	WA
Zip	:	98027-5395
Country	:	US
Telephone Number	:	425-269-6466
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 NW GILMAN BLVD
Second Line	:	E103/352
City	:	ISSAQUAH
State	:	WA
Zip	:	98027-5395
Country	:	US
Telephone Number	:	425-269-6466
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	07/08/2007

Similar Medicare Providers

1770504920 — DR. NEDA GOHARKHAY DDS
Practice Location Address:

700 NW GILMAN BLVD , SUITE E 101
ISSAQUAH, WA
98027-5395

Practice Phone: 425-369-9100
Practice Fax: 425-369-9536

1306911383 — TARJA KAAKKO
Practice Location Address:

700 NW GILMAN BLVD , SUITE E-103, #493
ISSAQUAH, WA
98027-5395

Practice Phone: 206-355-1596
Practice Fax: 425-369-9785

1568952257 — JOCELYN VELAZQUEZ
Practice Location Address:

450 NW GILMAN BLVD STE 105
ISSAQUAH, WA
98027-2483

Practice Phone: 425-651-4242
Practice Fax:

1093677932 — JENNIFER LEE KEILIN LICSW
Practice Location Address:

545 RAINIER BLVD N # 12
ISSAQUAH, WA
98027-2806

Practice Phone: 425-526-6556
Practice Fax: 425-270-1436

1447036280 — LEIGH BARRY HARVARD RN, BSN
Practice Location Address:

310 3RD AVE NE STE 124
ISSAQUAH, WA
98027-3350

Practice Phone: 206-501-4342
Practice Fax:

1174358535 — CARMELA WASILIK DPT
Practice Location Address:

405 NW GILMAN BLVD STE 200
ISSAQUAH, WA
98027-2470

Practice Phone: 425-392-6804
Practice Fax: 425-392-6805

Directions to “ MR. NATHAN O LAKE RN” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.