Organization
INTERNATIONAL COMMUNITY HEALTH SERVICES
Active
Other names
Holly Park Meical and Dental Clinic
Organization subpart
No
Provider details
NPI number
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 3007, SEATTLE, WA 98114-3007
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7137854
—
WA
Enumeration date
08/17/2007
Last updated
08/17/2007
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