| NPI | 1154792562 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGELIO RIOJAS Executive Director 206-788-3226 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: WA 6005372781) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA 6005372781) |
| Enumeration Date | 2015-10-12 |
| Last Update Date | 2015-10-12 |