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31405 18th Ave S Federal Way WA 98003-5433 | |
| (253) 681-6620 | |
| (253) 681-6648 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 31405 18th Ave S, Federal Way, Washington |
| Authorized Official Name and Position | Rogelio Riojas (CEO) |
| Authorized Official Contact | 2067883203 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 34703 Seattle WA 98124-1703 Ph: () - | 31405 18th Ave S Federal Way WA 98003-5433 Ph: (253) 681-6620 |
| NPI Number | 1700336708 |
|---|---|
| Provider Enumeration Date | 10/13/2016 |
| Last Update Date | 01/31/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700336708 | NPI | - | NPPES |
| 2076704 | Medicaid | WA |
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