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6004 Capitol Blvd Se Tumwater WA 98501-8520 | |
| (360) 704-7580 | |
| (360) 704-7567 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 6004 Capitol Blvd Se, Tumwater, 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 |
|---|---|
Po Box 34703 Seattle WA 98124-1703 Ph: () - | 6004 Capitol Blvd Se Tumwater WA 98501-8520 Ph: (360) 704-7580 |
| NPI Number | 1063069839 |
|---|---|
| Provider Enumeration Date | 08/26/2019 |
| Last Update Date | 01/31/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063069839 | NPI | - | NPPES |
| 2145315 | Medicaid | WA |
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