# INTERNATIONAL COMMUNITY HEALTH SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** INTERNATIONAL COMMUNITY HEALTH SERVICES
- **Other names:** Holly Park Medical & Dental Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1588743819
- **Legal business name:** INTERNATIONAL COMMUNITY HEALTH SERVICES
- **Authorized official:** HERMES SHAHBAZIAN (ASSISTANT FINANCE MANAGER)
- **Authorized official phone:** (206) 788-3618

## Contact information

- **Practice address:** 3815 S OTHELLO ST, 2ND FL., SEATTLE, WA 98118-3510
- **Practice address phone:** (206) 788-3500
- **Practice address fax:** (206) 788-3523
- **Mailing address:** PO BOX 3007, SEATTLE, WA 98114-3007
- **Mailing address phone:** (206) 788-3600
- **Mailing address fax:** (206) 652-5216

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 600436519 | WA | Yes |

## Other

- **Enumeration date:** 11/06/2006
- **Last updated:** 03/29/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 5047345 | — | WA |