| |
4111 Alderwood Mall Blvd Lynnwood WA 98036-6765 | |
(425) 977-2560 | |
(425) 977-2562 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 4111 Alderwood Mall Blvd, Lynnwood, Washington |
Authorized Official Name and Position | Rogelio Riojas (CEO) |
Authorized Official Contact | 2067635277 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 34703 Seattle WA 98124-1703 Ph: () - | 4111 Alderwood Mall Blvd Lynnwood WA 98036-6765 Ph: (425) 977-2560 |
NPI Number | 1598948093 |
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Provider Enumeration Date | 12/07/2007 |
Last Update Date | 01/31/2025 |
Identifier | Type | State | Issuer |
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1598948093 | NPI | - | NPPES |
1092233 | Medicaid | WA |
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