| |
2101 E Yesler Way Suite 150 Seattle WA 98122-5959 | |
(206) 299-1900 | |
(206) 299-1906 |
Full Name | |
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Speciality | Clinic/Center |
Location | 2101 E Yesler Way, Seattle, Washington |
Authorized Official Name and Position | Angie Treptow (INTERIM DIRECTOR OF FINANCE) |
Authorized Official Contact | 2062991937 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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2101 E Yesler Way Suite 210 Seattle WA 98122-5959 Ph: (206) 709-7112 | 2101 E Yesler Way Suite 150 Seattle WA 98122-5959 Ph: (206) 299-1900 |
NPI Number | 1164642278 |
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Provider Enumeration Date | 04/30/2007 |
Last Update Date | 05/20/2024 |
Medicare PECOS PAC ID | 8628966173 |
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Medicare Enrollment ID | O20120112000013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1164642278 | NPI | - | NPPES |
0016943 | Other | WA | LABOR & INDUSTRIES |
7402852 | Medicaid | WA | |
1023161 | Medicaid | WA | |
7900632 | Medicaid | WA | |
7056617 | Medicaid | WA |
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