| NPI | 1285147892 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOLEE ANN ELIZABETH SANKEY Provider Enrollment Specialist 206-474-2001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QF0050X Clinic/Center Family Planning, Non-Surgical |
| Enumeration Date | 2017-11-06 |
| Last Update Date | 2017-11-06 |