CHET JANGALA, MD
NPI 1669647152
Clinic/Center - Medical Specialty in Maple Valley, WA

Q: What is Lake Wilderness Medical Clinic LLC's NPI number?

The NPI number for Lake Wilderness Medical Clinic LLC is 1669647152. It was assigned to this organization in the NPPES registry on April 25, 2008. The provider is doing business as Chet Jangala, MD.

Q: What is Lake Wilderness Medical Clinic LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.

Active since April 25, 2008

26907 MAPLE VALLEY BLACK DIAMOND RD SE, MAPLE VALLEY, WA 98038(425) 432-9611(206) 973-5399 Get Directions Write a Review

NPPES record last updated: April 25, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Chet Jangala, Md NPPES

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

CHET JANGALA, MD (NPI 1669647152) is a healthcare organization registered as a medical specialty in Maple Valley, Washington and active in the NPI registry since April 2008. The organization lists Chester Edmond Jangala, Physician, as its authorized official.

NPPES Registry Identity

NPI1669647152

Entity TypeOrganization

Primary Taxonomy261QM2500X

Legal Business NameLAKE WILDERNESS MEDICAL CLINIC LLC

Location Address26907 MAPLE VALLEY BLACK DIAMOND RD SEMaple Valley, WA 98038-8314

Mailing AddressPo Box 1142Ravensdale, WA 98051-1142 · (425) 432-9611 · Fax (206) 973-5399

Phone(425) 432-9611

Fax(206) 973-5399

Organization SubpartNo

Authorized OfficialChester Edmond JangalaPhysician · (425) 432-9611

Enumeration DateApril 25, 2008

✔ NPI 1669647152 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Medical SpecialtyAmbulatory Health Care Facilities

Taxonomy Code261QM2500X

License✔ Licensed in WA · 602777613

Definition

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

26907 MAPLE VALLEY BLACK DIAMOND RD SE, Maple Valley, WA 98038

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Other Names 1

Doing Business AsChet Jangala, Md

Other Providers at the Same Location NPPES

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

LAKE WILDERNESS MEDICAL CLINIC LLC

Exclusive Provider Organization

26907 MAPLE VALLEY BLACK DIAMOND RD SE
MAPLE VALLEY, WA 98038

King County (425) 432-9611

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 Lake Wilderness Medical Clinic LLC's NPI number?

The NPI number for Lake Wilderness Medical Clinic LLC is 1669647152. It was assigned to this organization in the NPPES registry on April 25, 2008. The provider is doing business as Chet Jangala, MD.

Where is Lake Wilderness Medical Clinic LLC located?

Lake Wilderness Medical Clinic LLC is located at 26907 Maple Valley Black Diamond Rd SE, Maple Valley, WA 98038. The listed phone number is (425) 432-9611.

What is Lake Wilderness Medical Clinic LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.

When was this NPI record last updated?

The NPPES record for Lake Wilderness Medical Clinic LLC was last updated on April 25, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.