| NPI | 1780876284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN ARDELL MOE Practice Management Administrator 206-263-8807 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2007-08-17 |
| Last Update Date | 2022-10-13 |