| Community Health Center Of Snohomish County Lynnwood | |
|
4111 194th St Sw Ste 100 Lynnwood WA 98036-4604 | |
| (425) 835-5200 | |
| (425) 835-5201 |
| Full Name | Community Health Center Of Snohomish County Lynnwood |
|---|---|
| Speciality | Clinic/Center |
| Location | 4111 194th St Sw Ste 100, Lynnwood, Washington |
| Authorized Official Name and Position | Kenneth M Green (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4257893700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Health Center Of Snohomish County Lynnwood Po Box 13060 Everett WA 98206-3060 Ph: (425) 789-3700 | Community Health Center Of Snohomish County Lynnwood 4111 194th St Sw Ste 100 Lynnwood WA 98036-4604 Ph: (425) 835-5200 |
| NPI Number | 1013049741 |
|---|---|
| Provider Enumeration Date | 03/09/2007 |
| Last Update Date | 09/22/2010 |
| Medicare PECOS PAC ID | 0446152003 |
|---|---|
| Medicare Enrollment ID | O20101101000968 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013049741 | NPI | - | NPPES |
| 7034036 | Medicaid | WA | |
| 32770 | Other | WA | WORKMAN COMPENSATION |
| 8934243 | Other | WA | CRIME VICTIM COMPENSATION |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 7034036 (Washington) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 7034036 (Washington) | Primary |
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