Organization · Type 2 NPI

International Community Health Services

Family Medicine Physician · Seattle, WA

NPI number 1104940733 Active

Practice location

3815 S Othello St, 2nd Floor
Seattle, WA 98118-3510

Call (206) 788-3500 Map

Fax (206) 788-3521

Mailing address

PO Box 24911
Seattle, WA 98124-0911

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician Primary	207Q00000X	None listed

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

37 other providers at this address

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NPI record

NPI: 1104940733
Entity type: Organization (Type 2)
Issued: Mar 19, 2007
Last updated: Dec 20, 2007
Status: Active
Subpart: Yes of International Community Health Services

Other names

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Holly Park Medical & Dental Clinic · other name

Authorized official

Peggy Phung
Assistant Finance Manager
(206) 788-3605

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1104940733

International Community Health Services's National Provider Identifier is 1104940733, issued on Mar 19, 2007. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Seattle, WA. The record was last updated on Dec 20, 2007.