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597 Point Brown Ave Nw Ocean Shores WA 98569-9632 | |
| (360) 289-2415 | |
| (360) 289-2843 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 597 Point Brown Ave Nw, Ocean Shores, Washington |
| Authorized Official Name and Position | Rogelio Riojas (CEO) |
| Authorized Official Contact | 2067635277 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 34703 Seattle WA 98124-1703 Ph: () - | 597 Point Brown Ave Nw Ocean Shores WA 98569-9632 Ph: (360) 289-2415 |
| NPI Number | 1790136943 |
|---|---|
| Provider Enumeration Date | 06/29/2016 |
| Last Update Date | 01/31/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790136943 | NPI | - | NPPES |
| 2062429 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |