| NPI | 1336715762 |
|---|---|
| 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 | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2021-05-27 |
| Last Update Date | 2021-05-27 |