Organization
SEATTLE INDIAN HEALTH BOARD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ESTHER LUCERO (CEO)
(206) 324-9360
Entity
Organization
Contact information
Practice address
611 12TH AVE S, SUITE 200, SEATTLE, WA 98144-1910
(206) 324-9360
(206) 324-8910
Mailing address
611 12TH AVE S, SEATTLE, WA 98144-1910
(206) 324-9360
(206) 324-8910
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5010954
—
WA
Enumeration date
11/22/2006
Last updated
03/12/2021
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