| |
3639 Martin Luther King Jr Way S Seattle WA 98144-6847 | |
(206) 695-7600 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 3639 Martin Luther King Jr Way S, Seattle, Washington |
Authorized Official Name and Position | Hermes Shahbazian (CFO) |
Authorized Official Contact | 2067883618 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 3007 Seattle WA 98114-3007 Ph: () - | 3639 Martin Luther King Jr Way S Seattle WA 98144-6847 Ph: (206) 695-7600 |
NPI Number | 1356757389 |
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Provider Enumeration Date | 07/10/2014 |
Last Update Date | 03/29/2021 |
Identifier | Type | State | Issuer |
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1356757389 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 600436519 (Washington) | Primary |
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