| |
113 23rd Ave S Seattle WA 98144-2309 | |
(206) 219-5980 | |
(206) 812-6161 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 113 23rd Ave S, Seattle, 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: () - | 113 23rd Ave S Seattle WA 98144-2309 Ph: (206) 219-5980 |
NPI Number | 1881062362 |
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Provider Enumeration Date | 09/14/2015 |
Last Update Date | 01/31/2025 |
Identifier | Type | State | Issuer |
---|---|---|---|
1881062362 | NPI | - | NPPES |
2218574 | Medicaid | WA |
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