Lake Wilderness Medical Clinic LLC
NPI 1982879045 · Exclusive Provider Organization · Maple Valley, WA
Lake Wilderness Medical Clinic LLC is a Exclusive Provider Organization organization in Maple Valley, WA (NPI 1982879045).
Provider details
- NPI number
- 1982879045
- Entity type
- Organization
- Primary specialty
- Exclusive Provider OrganizationManaged Care Organizations
- Organization subpart
- No
- Authorized official
- Chester Jangala, Physician(425) 432-9611
- License
- MD00023662 (WA)
Specialties & taxonomies
Managed Care Organizations
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 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
Registry dates
- Enumerated
- 2008-04-29
- Last updated
- 2008-04-29
Frequently asked questions
- What is Lake Wilderness Medical Clinic LLC's NPI number?
- Lake Wilderness Medical Clinic LLC's National Provider Identifier (NPI) is 1982879045, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Lake Wilderness Medical Clinic LLC?
- Lake Wilderness Medical Clinic LLC is classified in the NPPES registry as Exclusive Provider Organization (Managed Care Organizations).
- Where is Lake Wilderness Medical Clinic LLC located?
- Lake Wilderness Medical Clinic LLC's practice location on file with NPPES is 26907 Maple Valley Black Diamond Rd Se, Maple Valley, WA 98038-8314.
- What is Lake Wilderness Medical Clinic LLC's phone number?
- The practice phone number listed in the NPPES registry for Lake Wilderness Medical Clinic LLC is (425) 432-9611.
- Who is the authorized official for Lake Wilderness Medical Clinic LLC?
- The authorized official listed on Lake Wilderness Medical Clinic LLC's NPPES record is Chester Jangala, Physician. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Lake Wilderness Medical Clinic LLC's NPI active?
- Yes — Lake Wilderness Medical Clinic LLC's NPI (1982879045) is active in the NPPES registry as of the last update on 2008-04-29.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.