=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831122449
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARY E LAMBE MD FAAFP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/08/2006
-----------------------------------------------------
Last Update Date | 02/03/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 38700 SE RIVER STREET SNOQUALMIE VALLEY CLINIC
-----------------------------------------------------
City | SNOQUALMIE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98065
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 425-888-2299
-----------------------------------------------------
Fax | 425-888-1204
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 2013
-----------------------------------------------------
City | SNOQUALMIE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98065-2013
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 425-888-2299
-----------------------------------------------------
Fax | 425-888-1204
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 21508
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | DR-45006
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------