Holly Park Medical & Dental Clinic

LBN: International Community Health Services
Holly Park Medical & Dental Clinic is an health care organization with primary practice located at 3815 S Othello St 2Nd Fl., Seattle WA 98118-3510. The organization recently has only one registered license in Dental Providers / Dentist, which is considered as the primary health care specialty. International Community Health Services can be contacted via phone (206) 788-3500, or through Shahbazian, Hermes via phone (206) 788-3618.

Contact Information

Primary practice address
3815 S Othello St 2Nd Fl. Seattle WA 98118-3510
Phone: (206) 788-3500
Fax: (206) 788-3523
Website:
Map and Directions
Authorized official contact:
Name: Shahbazian, Hermes
Phone: (206) 788-3618

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 600436519 Washington

Profile Details

NPI number 1588743819
LBN Legal business name International Community Health Services
DBA Doing business as Holly Park Medical & Dental Clinic
Authorized official Shahbazian, Hermes
Entity Organization
Organization subpart 1 Yes
Enumeration date Nov 6th, 2006
Last updated Mar 29th, 2021 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588743819 NPPES
Washington MEDICAID 5047345

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