NPI | 1679766620 |
---|---|
Entity Type | Organization |
Authorized Contact | ROGELIO RIOJAS CEO 206-763-5277 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) (Licence: WA 6 H80CS00 455-05-03) |
Additional Taxonomies | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder (Licence: WA 6 H80CS00 455-05-03) |
Enumeration Date | 2007-08-23 |
Last Update Date | 2025-01-31 |