Organization
SEATTLE INDIAN HEALTH BOARD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ESTHER LUCERO MPP (EXECUTIVE DIRECTOR)
(206) 324-9360
Entity
Organization
Contact information
Practice address
611 12TH AVE S, 200, SEATTLE, WA 98144-1910
(206) 324-9360
(206) 324-8910
Mailing address
PO BOX 3364, SEATTLE, WA 98114-3364
(206) 324-9360
(206) 324-8910
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
600440936
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50D0065434
CLIA LAB
WA
Enumeration date
02/02/2007
Last updated
12/30/2020
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