NPI | 1376118695 |
---|---|
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 |
261QM2500X Clinic/Center, Medical Specialty | |
Enumeration Date | 2021-05-20 |
Last Update Date | 2021-05-20 |