| NPI | 1497106645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGELIO RIOJAS CEO 206-763-5277 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| 1223G0001X Dentist, General Practice | |
| 1223P0221X Dentist, Pediatric Dentistry | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2016-06-29 |
| Last Update Date | 2023-09-11 |