Healthcare Provider Details

I. General information

NPI: 1639985922
Provider Name (Legal Business Name): INTERNATIONAL COMMUNITY HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2024
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16549 AURORA AVE N FL 3
SHORELINE WA
98133-5308
US

IV. Provider business mailing address

PO BOX 3007
SEATTLE WA
98114-3007
US

V. Phone/Fax

Practice location:
  • Phone: 206-880-2144
  • Fax: 206-866-9114
Mailing address:
  • Phone: 206-880-2144
  • Fax: 206-866-9114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL

VIII. Authorized Official

Name: HERMES SHAHBAZIAN
Title or Position: CFO
Credential:
Phone: 206-788-3618