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General NPI Number Information
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NPI Number | 1407152952
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Entity Type | Organization
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Legal Business Name | LAKE AND LEMERY, PLLC
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Dates
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Enumeration Date | 02/01/2011
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Last Update Date | 02/01/2011
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Provider Practice Location Address
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Address Line | 14420 BEL RED RD STE 105
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City | BELLEVUE
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State | WA
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Zip | 98007-3930
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Country | US
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Telephone | 425-641-4200
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Fax | 425-641-4418
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Provider Business Mailing Address
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Address Line | 14420 BEL RED RD STE 105
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City | BELLEVUE
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State | WA
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Zip | 98007-3930
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Country | US
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Telephone | 425-641-4200
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Fax | 425-641-4418
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | CHARLOTTE LEMERY
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Credential |
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Telephone | 425-641-4200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 603066082
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License Number State | WA
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