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General NPI Number Information
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NPI Number | 1427109271
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Entity Type | Organization
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Legal Business Name | LAKE WASHINGTON PRIVATE MEDICINE INC
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 01/01/2024
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Provider Practice Location Address
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Address Line | 13122 120TH AVE NE
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City | KIRKLAND
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State | WA
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Zip | 98034-3014
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Country | US
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Telephone | 425-678-8534
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Fax | 425-678-8564
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Provider Business Mailing Address
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Address Line | 13122 120TH AVE NE
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City | KIRKLAND
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State | WA
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Zip | 98034-3014
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Country | US
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Telephone | 425-678-8534
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Fax | 425-678-8564
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID KEITH NAIBERT
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Credential | MD
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Telephone | 425-678-8534
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | 602289671
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License Number State | WA
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