| NPI | 1114501947 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA LAFONTAINE Revenue Cycle Manager 206-324-4036 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2021-05-07 |
| Last Update Date | 2021-05-07 |