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LAKE SERENE CLINIC
NPI 1003809229
Clinic/Center - Primary Care in Lynnwood, WA

Active since August 23, 2005CLIA 50D0630514 · Microscopy
3501 SHELBY RD, SUITE B, LYNNWOOD, WA 98087(425) 742-9119 Get Directions Write a Review

NPPES record last updated: February 23, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Feb 23, 2016, Feb 17, 2016 (2 updates tracked since 2016).

About Lake Serene Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAKE SERENE CLINIC (NPI 1003809229) is a healthcare organization registered as a primary care in Lynnwood, Washington and active in the NPI registry since August 2005. The organization holds a CLIA Microscopy certificate valid through April 4, 2028 and lists Corey Don Friesen, Ceo Administrator, as its authorized official.

NPPES Registry Identity

NPI1003809229
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameWESTERN WASHINGTON MEDICAL GROUP, INC PS
Location Address3501 SHELBY RD, SUITE BLynnwood, WA 98087-3599
Mailing Address3501 Shelby Rd, Suite BLynnwood, WA 98087-3599 · (425) 742-9119
Phone(425) 742-9119
Organization SubpartYes
Authorized OfficialCorey Don FriesenCeo Administrator · (425) 742-9119
Enumeration DateAugust 23, 2005
Last NPPES UpdateFebruary 23, 20162 updates tracked since enumeration
✔ NPI 1003809229 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
3501 SHELBY RD, Lynnwood, WA 98087
Open in Google Maps ↗

Other Names 1

Doing Business AsLake Serene Clinic

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 50D0630514

Lake Serene Clinic · Lynnwood, WA
Active · expires Apr 4, 2028
CLIA Number50D0630514
Laboratory TypeClinic
Certificate Effective DateJune 29, 2022
Certificate Expiration DateApril 4, 2028
Laboratory DirectorAndrea Friesen
Laboratory Phone(425) 742-9119
Laboratory LocationLake Serene Clinic3501 Shelby Rd Ste B, Lynnwood, WA 98087
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. JOSHUA MICHAEL WEBB RN, MSN, ARNP
Nurse Practitioner (Family)
3501 SHELBY RD, SUITE B
LYNNWOOD, WA 98087
Snohomish County (425) 742-9119
MR. ANDREW R KRUSE ARNP
Nurse Practitioner (Family)
3501 SHELBY RD, SUITE B
LYNNWOOD, WA 98087
Snohomish County (425) 742-9119
MR. CHAD ERIC TRIPLETT L.M.P.
Specialist
3501 SHELBY RD, SUITE C
LYNNWOOD, WA 98087
Snohomish County (425) 745-9052
SERENE LAKE MASSAGE THERAPY
Specialist
3501 SHELBY RD, SUITE C
LYNNWOOD, WA 98087
Snohomish County (425) 745-9052
RENEE LYNNE DAVIS LMP
Specialist
3501 SHELBY RD, SUITE C
LYNNWOOD, WA 98087
Snohomish County (425) 745-9052
MRS. ANDREA LYNN FRIESEN RN, MSN, ARNP
Registered Nurse
3501 SHELBY RD, SUITE B
LYNNWOOD, WA 98087
Snohomish County (425) 742-9119
MR. GREGORY ALAN LIND RN, MSN, ARNP
Nurse Practitioner (Family)
3501 SHELBY RD, SUITE B
LYNNWOOD, WA 98087
Snohomish County (425) 742-9119

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Western Washington Medical Group, Inc Ps's NPI number?

The NPI number for Western Washington Medical Group, Inc Ps is 1003809229. It was assigned to this organization in the NPPES registry on August 23, 2005. The provider is doing business as Lake Serene Clinic.

Where is Western Washington Medical Group, Inc Ps located?

Western Washington Medical Group, Inc Ps is located at 3501 Shelby Rd Suite B, Lynnwood, WA 98087. The listed phone number is (425) 742-9119.

What is Western Washington Medical Group, Inc Ps's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Western Washington Medical Group, Inc Ps hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 50D0630514) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Western Washington Medical Group, Inc Ps accept?

Health plans from Premera Blue Cross Blue Shield of Alaska list Western Washington Medical Group, Inc Ps as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Western Washington Medical Group, Inc Ps was last updated on February 23, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.