Southlake Clinic Inc., P.s.
NPI 1104962331 · Internal Medicine Physician · Renton, WA
Southlake Clinic Inc., P.s. is a Internal Medicine Physician organization in Renton, WA (NPI 1104962331).
Provider details
- NPI number
- 1104962331
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- James Hudson, Coo(425) 793-4725
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Dermatology Physician207N00000X
Allopathic & Osteopathic Physicians
- Cardiovascular Disease Physician207RC0000X
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
- Gastroenterology Physician207RG0100X
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Former legal business name
- Valley Internal Medicine Inc Ps
Registry dates
- Enumerated
- 2007-01-29
- Last updated
- 2017-07-13
Frequently asked questions
- What is Southlake Clinic Inc., P.s.'s NPI number?
- Southlake Clinic Inc., P.s.'s National Provider Identifier (NPI) is 1104962331, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Southlake Clinic Inc., P.s.?
- Southlake Clinic Inc., P.s. is classified in the NPPES registry as Internal Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Southlake Clinic Inc., P.s. located?
- Southlake Clinic Inc., P.s.'s practice location on file with NPPES is 4011 Talbot Rd S, Renton, WA 98055-5773.
- What is Southlake Clinic Inc., P.s.'s phone number?
- The practice phone number listed in the NPPES registry for Southlake Clinic Inc., P.s. is (425) 251-5110.
- Who is the authorized official for Southlake Clinic Inc., P.s.?
- The authorized official listed on Southlake Clinic Inc., P.s.'s NPPES record is James Hudson, Coo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Southlake Clinic Inc., P.s.'s NPI active?
- Yes — Southlake Clinic Inc., P.s.'s NPI (1104962331) is active in the NPPES registry as of the last update on 2017-07-13.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.