| NPI | 1942358262 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY BARTOLO Deputy Director 206-788-3224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: WA 6005372781) |
| Additional Taxonomies | 122300000X Dentist |
| 1223G0001X Dentist, General Practice | |
| 1223P0221X Dentist, Pediatric Dentistry | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| 122400000X Denturist | |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2023-09-11 |