NPI | 1992124747 |
---|---|
Other Name | ICHS SHORELINE MEDICAL AND DENTAL CLINIC |
Entity Type | Organization |
Authorized Contact | HERMES SHAHBAZIAN CFO 206-788-3606 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: WA 600436519) |
Additional Taxonomies | 207Q00000X Family Medicine |
251B00000X Case Management | |
Enumeration Date | 2014-04-09 |
Last Update Date | 2021-03-29 |