# PUBLIC HOSPITAL DISTRICT \#1 OF KING COUNTY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** VMC Kent Primary Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376590026
- **Authorized official:** MELISSA FARLEY CPC (TECHNICAL COORDINATOR)
- **Authorized official phone:** (425) 917-6282

## Contact information

- **Practice address:** 24920 104TH AVE SE, KENT, WA 98030-6443
- **Practice address phone:** (253) 395-2000
- **Practice address fax:** (253) 395-1956
- **Mailing address:** 3600 LIND AVE SW, SUITE 100, RENTON, WA 98055-4934
- **Mailing address phone:** (425) 656-5412
- **Mailing address fax:** (425) 656-5423

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 103T00000X | Psychologist | — | NULL | — |
| 103T00000X | Psychologist | — | — | — |
| 106H00000X | Marriage & Family Therapist | — | NULL | — |
| 106H00000X | Marriage & Family Therapist | — | — | — |
| 207QA0505X | Adult Medicine Physician | — | NULL | Yes |
| 207QA0505X | Adult Medicine Physician | — | — | Yes |
| 363AM0700X | Medical Physician Assistant | — | NULL | — |
| 363AM0700X | Medical Physician Assistant | — | — | — |

## Other

- **Enumeration date:** 05/28/2006
- **Last updated:** 01/15/2008