Organization
INTERNATIONAL COMMUNITY HEALTH SERVICES
Active
Parent organization
INTERNATIONAL COMMUNITY HEALTH SERVICES
Other names
Holly Park Medical and Dental Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
INTERNATIONAL COMMUNITY HEALTH SERVICES
Authorized official
PEGGY PHUNG (ASSISTANT FINANCE MANAGER)
(206) 788-3605
Entity
Organization
Contact information
Practice address
3815 S OTHELLO ST, 2ND FL., SEATTLE, WA 98118-3510
(206) 788-3500
(206) 788-3521
Mailing address
PO BOX 24911, SEATTLE, WA 98124-0911
(206) 788-3600
(206) 652-5216
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7094196
—
WA
05
—
7125297
—
WA
Enumeration date
04/26/2007
Last updated
12/20/2007
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