Country Doctor Community Clinic

LBN: Seattle Roots Community Health
Country Doctor Community Clinic is an health care organization with primary practice located at 500 19Th Ave E , Seattle WA 98112-4007. The organization recently has 3 registered licenses in different health care specialties including Agencies / Case Management, Ambulatory Health Care Facilities / Community Health, Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC). Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) is the primary health care specialty. Seattle Roots Community Health can be contacted via phone (206) 299-1600, or through Treptow, Angie via phone (206) 299-1937.

Contact Information

Primary practice address
500 19Th Ave E Seattle WA 98112-4007
Phone: (206) 299-1600
Fax: (206) 299-1608
Website:
Map and Directions
Authorized official contact:
Name: Treptow, Angie
Phone: (206) 299-1937

Health care specialties

SpecialtyCodeLicense #State
Agencies / Case Management 251B00000X
Ambulatory Health Care Facilities / Community Health 261QC1500X 601583685 Washington
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X

Profile Details

NPI number 1629055900
LBN Legal business name Seattle Roots Community Health
DBA Doing business as Country Doctor Community Clinic
Authorized official Treptow, Angie
Entity Organization
Organization subpart 1 Yes
Enumeration date Dec 28th, 2005
Last updated May 20th, 2024 - about 4 months 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 1629055900 NPPES
Washington MEDICAID 8016081
Washington MEDICAID 7034044
Washington MEDICAID 7034598
Washington MEDICAID 6013965
Washington MEDICAID 7900632
Washington MEDICAID 1014895
Washington Other 16943
Washington MEDICAID 6014948
Washington Other 600508852
Washington MEDICAID 7590243
Washington MEDICAID 8016438
Washington MEDICAID 8064602

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