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 Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTY
Authorized official
MR. KENNETH M GREEN (PT ACCOUNT MANAGER)
(425) 789-3700
Entity
Organization
Contact information
Practice address
4111 194TH ST SW, SUITE 200, LYNNWOOD, WA 98036-4604
(425) 835-5204
(425) 835-5205
Mailing address
PO BOX 13060, EVERETT, WA 98206-3060
(425) 789-3700
(425) 789-3750
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7034036
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32770
WORKMEN COMPENSATION
WA
05
—
5010921
—
WA
01
—
8934243
CRIME VICTIMS COMPENSATIO
WA
Enumeration date
03/08/2007
Last updated
06/13/2008
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