| |
2101 E Yesler Way Suite 100 Seattle WA 98122-5959 | |
(206) 987-7200 | |
(206) 987-7206 |
Full Name | |
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Speciality | Clinic/center - Student Health |
Location | 2101 E Yesler Way, Seattle, Washington |
Authorized Official Name and Position | Suzanne Beitel (SVP AND CFO) |
Authorized Official Contact | 2069874153 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 5371 Rc-504 Seattle WA 98145-5020 Ph: (206) 987-5770 | 2101 E Yesler Way Suite 100 Seattle WA 98122-5959 Ph: (206) 987-7200 |
NPI Number | 1841322252 |
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Provider Enumeration Date | 03/12/2007 |
Last Update Date | 09/28/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1841322252 | NPI | - | NPPES |
7900962 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QS1000X | Clinic/center - Student Health | (* (Not Available)) | Primary |
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