Organization
INTERNATIONAL COMMUNITY HEALTH SERVICES
Active
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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