| NPI | 1104039320 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK LLOYD SECORD Executive Director 206-461-6935 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2011-09-19 |