| |
1600 S Columbian Way Seattle WA 98108-1565 | |
(206) 762-2394 | |
(206) 762-2421 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 1600 S Columbian Way, Seattle, Washington |
Authorized Official Name and Position | Mark Secord (CEO) |
Authorized Official Contact | 2065483050 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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905 Spruce St Ste 300 Seattle WA 98104-2474 Ph: (206) 548-3114 | 1600 S Columbian Way Seattle WA 98108-1565 Ph: (206) 762-2394 |
NPI Number | 1568716108 |
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Provider Enumeration Date | 11/05/2012 |
Last Update Date | 11/05/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1568716108 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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