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Lake Wilderness Medical Clinic LLC

Exclusive Provider Organization in Maple Valley, WA · enumerated 2008 · authorized official Chester Jangala, Physician.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1982879045

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Registry record

Entity type Organization (Type 2)
Legal business name Lake Wilderness Medical Clinic LLC
Practice address 26907 Maple Valley Black Diamond Rd Se, Maple Valley, WA, 98038
Phone (425) 432-9611
Fax (206) 973-5399
Enumeration date Apr 29, 2008
Last updated in NPPES Apr 29, 2008

Taxonomy & classification

302F00000X Exclusive Provider Organization Managed Care Organizations · License MD00023662 (WA) Primary

Authorized official

Name Chester Jangala
Title Physician
Phone (425) 432-9611

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Who is the authorized official for Lake Wilderness Medical Clinic LLC?
NPPES lists Chester Jangala (Physician) as the authorized official for this organization.
What is the NPI number for Lake Wilderness Medical Clinic LLC?
The NPI for Lake Wilderness Medical Clinic LLC is 1982879045, a Type 2 (organization) record in the CMS NPPES registry.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2008-04-29.