Organization
INTERNATIONAL COMMUNITY HEALTH SERVICES
Active
Parent organization
INTERNATIONAL COMMUNITY HEALTH SERVICES
Other names
Holly Park Medical & Dental Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
INTERNATIONAL COMMUNITY HEALTH SERVICES
Authorized official
HERMES SHAHBAZIAN (ASSISTANT FINANCE MANAGER)
(206) 788-3618
Entity
Organization
Contact information
Practice address
3815 S OTHELLO ST, 2ND FL., SEATTLE, WA 98118-3510
(206) 788-3500
(206) 788-3523
Mailing address
PO BOX 3007, SEATTLE, WA 98114-3007
(206) 788-3600
(206) 652-5216
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
600436519
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5047345
—
WA
Enumeration date
11/06/2006
Last updated
03/29/2021
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