| |
13028 S Interurban Ave #106 Tukwila WA 98168-3340 | |
(206) 957-7950 | |
(206) 957-7952 |
Full Name | |
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Speciality | Clinic/center |
Location | 13028 S Interurban Ave, Tukwila, Washington |
Authorized Official Name and Position | Perry L. Chinn (PRESIDENT) |
Authorized Official Contact | 2069577950 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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13028 S Interurban Ave #106 Tukwila WA 98168-3340 Ph: (206) 957-7950 | 13028 S Interurban Ave #106 Tukwila WA 98168-3340 Ph: (206) 957-7950 |
NPI Number | 1528115896 |
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Provider Enumeration Date | 01/05/2007 |
Last Update Date | 12/06/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1528115896 | NPI | - | NPPES |
CH4243 | Other | WA | REGENCE BLUE SHIELD |
2032399 | Medicaid | WA | |
160573 | Other | WA | LABOR AND INDUSTRY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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