| |
8915 14th Ave S Fl 2 Seattle WA 98108-4813 | |
(206) 762-3263 | |
(206) 763-6574 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 8915 14th Ave S Fl 2, Seattle, Washington |
Authorized Official Name and Position | Mary Bartolo (DEPUTY DIRECTOR) |
Authorized Official Contact | 2067883224 |
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: () - | 8915 14th Ave S Fl 2 Seattle WA 98108-4813 Ph: (206) 762-3263 |
NPI Number | 1942358262 |
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Provider Enumeration Date | 01/05/2007 |
Last Update Date | 01/31/2025 |
Identifier | Type | State | Issuer |
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1942358262 | NPI | - | NPPES |
1022872 | Medicaid | WA |
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