Organization
COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTY
Active
Parent organization
COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTY
Other names
Community Health Center of Snohomish County Lynnwood
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTY
Authorized official
MR. KENNETH M GREEN (EXECUTIVE DIRECTOR)
(425) 789-3700
Entity
Organization
Contact information
Practice address
4111 194TH ST SW STE 100, LYNNWOOD, WA 98036-4604
(425) 835-5200
(425) 835-5201
Mailing address
PO BOX 13060, EVERETT, WA 98206-3060
(425) 789-3700
(425) 789-3750
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
7034036
WA
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
7034036
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32770
WORKMAN COMPENSATION
WA
05
—
7034036
—
WA
01
—
8934243
CRIME VICTIM COMPENSATION
WA
Enumeration date
03/09/2007
Last updated
09/22/2010
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