Organization
INTERNATIONAL COMMUNITY HEALTH SERVICES
Active
Parent organization
600436519
Other names
ICHS Shoreline Medical and Dental Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
600436519
Authorized official
HERMES SHAHBAZIAN (CFO)
(206) 788-3606
Entity
Organization
Contact information
Practice address
16549 AURORA AVE N, SHORELINE, WA 98133-5308
(206) 533-2600
(206) 533-2641
Mailing address
PO BOX 3007, SEATTLE, WA 98114-3007
(206) 788-3700
(206) 788-3706
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
251B00000X
Case Management Agency
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
600436519
WA
Other
Enumeration date
04/09/2014
Last updated
03/29/2021
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