Healthcare Provider Details

I. General information

NPI: 1124150859
Provider Name (Legal Business Name): COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 07/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1424 BROADWAY
EVERETT WA
98201-1720
US

IV. Provider business mailing address

8609 EVERGREEN WAY
EVERETT WA
98208-2619
US

V. Phone/Fax

Practice location:
  • Phone: 425-789-2050
  • Fax: 425-789-2070
Mailing address:
  • Phone: 425-789-3700
  • Fax: 425-789-3750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License NumberCF00056988
License Number StateWA

VIII. Authorized Official

Name: MR. ROBERT M FARRRELL
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 425-789-3700