Healthcare Provider Details

I. General information

NPI: 1205993508
Provider Name (Legal Business Name): SEATTLE-KING COUNTY DEPT OF PUBLIC HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 10/13/2022
Certification Date: 10/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 5TH AVE SUITE 1200
SEATTLE WA
98104-2333
US

IV. Provider business mailing address

400 YESLER WAY SUITE 300
SEATTLE WA
98104-2628
US

V. Phone/Fax

Practice location:
  • Phone: 206-205-5975
  • Fax:
Mailing address:
  • Phone: 206-205-5975
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KEVIN ARDELL MOE
Title or Position: PRACTICE MANAGEMENT ADMINISTRATOR
Credential:
Phone: 206-263-8807