Healthcare Provider Details

I. General information

NPI: 1982052874
Provider Name (Legal Business Name): NEIGHBORCARE HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2016
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 12TH AVE S STE 401
SEATTLE WA
98144-2730
US

IV. Provider business mailing address

1200 12TH AVE S STE 901
SEATTLE WA
98144-2712
US

V. Phone/Fax

Practice location:
  • Phone: 206-548-5850
  • Fax: 206-328-4034
Mailing address:
  • Phone: 206-548-3114
  • Fax: 206-962-2342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number600138418
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number600138418
License Number StateWA

VIII. Authorized Official

Name: CHARISSE MARSHALL
Title or Position: DIRECTOR OF REVENUE CYCLE
Credential:
Phone: 206-548-3102