NPI | 1902983109 |
---|---|
Other Name | HOLLY PARK MEDICAL & DENTAL CLINIC |
Entity Type | Organization |
Authorized Contact | HERMES SHAHBAZIAN CFO 206-788-3618 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA 600436519) |
251B00000X Case Management | |
Enumeration Date | 2006-11-01 |
Last Update Date | 2021-04-07 |