Healthcare Provider Details

I. General information

NPI: 1437603099
Provider Name (Legal Business Name): NEIGHBORCARE HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2016
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10030 SW 210TH ST
VASHON WA
98070-6584
US

IV. Provider business mailing address

PO BOX 3835
SEATTLE WA
98124-3835
US

V. Phone/Fax

Practice location:
  • Phone: 206-463-3671
  • Fax: 206-463-3613
Mailing address:
  • Phone: 206-548-3102
  • Fax: 206-762-6355

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 Code103T00000X
TaxonomyPsychologist
License Number600138418
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: JANINE CHILDS
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 206-461-6935