Organization
COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTY
Active
Organization
COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTY
Active
Parent organization
COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTY
Other names
CHC of Snohomish County 112th Medical
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTY
Authorized official
MR. ROBERT C FARRELL (EXECUTIVE DIRECTOR)
(425) 789-3700
Entity
Organization
Contact information
Practice address
1019 112TH ST SW, EVERETT, WA 98204
(425) 551-6200
(425) 551-6017
Mailing address
PO BOX 13060, EVERETT, WA 98206-3060
(425) 789-3700
(425) 789-3750
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
7034036
WA
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
7034036
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32770
WORKER COMPENSATION
WA
05
—
7034036
—
WA
01
—
8934243
CRIME VICTIMS COMP
WA
Enumeration date
03/09/2007
Last updated
08/12/2011
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