OrganizationActive
Southlake Clinic Inc Ps
NPI 1538394234 · Anatomic Pathology Physician · Renton, WA
Provider details
- NPI number
- 1538394234
- Entity type
- Organization
- Primary specialty
- Anatomic Pathology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Marianne Larson, Coo(425) 251-5110
- License
- MD00015542 (WA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(85/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 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
4011 Talbot Rd S
Suite 500
Renton, WA 98055-5773
Phone: (425) 251-5110
Fax: (425) 793-4710
Street-level locationGet directions
Mailing address
Po Box 59028
Renton, WA 98058-2028
Other names (DBA / former)
- Doing business as
- Southlake Clinic Pathology
Registry dates
- Enumerated
- 2009-05-26
- Last updated
- 2012-08-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.