| |
1920 100th St Se Ste C2 Everett WA 98208-3832 | |
(425) 249-0770 | |
(425) 249-0771 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 1920 100th St Se Ste C2, Everett, Washington |
Authorized Official Name and Position | Rogelio Riojas (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 2067883226 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 34703 Seattle WA 98124-1703 Ph: (253) 681-6633 | 1920 100th St Se Ste C2 Everett WA 98208-3832 Ph: (425) 249-0770 |
NPI Number | 1477911410 |
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Provider Enumeration Date | 02/05/2016 |
Last Update Date | 01/31/2025 |
Identifier | Type | State | Issuer |
---|---|---|---|
1477911410 | NPI | - | NPPES |
2054913 | Medicaid | WA |
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