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13030 Military Rd S Suite 210 Tukwila WA 98168-3085 | |
(425) 277-1311 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 13030 Military Rd S, Tukwila, Washington |
Authorized Official Name and Position | Duane Nakamura (CREDENTIALING COORDINATOR) |
Authorized Official Contact | 4252771311 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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955 Powell Ave Sw Renton WA 98057-2908 Ph: (425) 277-1311 | 13030 Military Rd S Suite 210 Tukwila WA 98168-3085 Ph: (425) 277-1311 |
NPI Number | 1124482310 |
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Provider Enumeration Date | 04/13/2016 |
Last Update Date | 04/13/2016 |
Identifier | Type | State | Issuer |
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1124482310 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 600461511 (Washington) | Primary |
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