Healthcare Provider Details

I. General information

NPI: 1053172635
Provider Name (Legal Business Name): HEALTHPOINT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2024
Last Update Date: 04/03/2024
Certification Date: 04/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 AUBURN WAY N STE B
AUBURN WA
98002-4117
US

IV. Provider business mailing address

955 POWELL AVE SW
RENTON WA
98057-2908
US

V. Phone/Fax

Practice location:
  • Phone: 425-277-1311
  • Fax:
Mailing address:
  • Phone: 425-277-1311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: BRITTANY AYDELOTT
Title or Position: ENROLLMENT SPECIALIST
Credential:
Phone: 425-424-6329