LAKE SERENE CLINIC
NPI 1003809229
Clinic/Center - Primary Care in Lynnwood, WA
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
Specialties & Licenses
Other Names 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Lake Serene Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
90Medicare enrollment records show 90 clinicians reassign Medicare billing to Lake Serene Clinic, which bills Medicare for the services they deliver. Of these, 5 practice at this address and 67 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 21
Nearest to this location (20)
See all 90Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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, WAFrequently 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.
Is Western Washington Medical Group, Inc Ps enrolled in Medicare?
Yes. Western Washington Medical Group, Inc Ps is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Western Washington Medical Group, Inc Ps?
According to the CMS Revalidation Reassignment List (October 2026 release), 90 clinicians in 21 Medicare specialties reassign their Medicare billing to Western Washington Medical Group, Inc Ps. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (23), Family Practice (11) and Pulmonary Disease (9). Of these, 5 practice at this address and 67 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
# Lake Serene Clinic · NPI 1003809229
Primary Care organization in Lynnwood, Washington. Organization record, active in the CMS NPPES registry since August 23, 2005.
## Identity
- **NPI:** 1003809229 (Entity type: Organization)
- **Enumerated:** August 23, 2005
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Legal business name:** Western Washington Medical Group, Inc Ps
- **Organization subpart:** Yes (part of Western Washington Medical Group, Inc Ps)
- **Authorized official:** Corey Friesen, CEO ADMINISTRATOR
## Practice location
- **Address:** 3501 SHELBY RD, SUITE B, Lynnwood, WA 98087-3599
- **Phone:** (425) 742-9119
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 90 clinicians in 21 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (23), Family Practice (11), Pulmonary Disease (9); 5 practice at this address and 67 within 10 miles; [full list](https://npiprofile.com/npi/1003809229/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 23, 2016
- **CLIA laboratory certificates:** 1 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1003809229) · Data from the CMS NPPES public registry.