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General NPI Number Information
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NPI Number | 1639985922
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Entity Type | Organization
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Legal Business Name | INTERNATIONAL COMMUNITY HEALTH SERVICES
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Dates
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Enumeration Date | 12/10/2024
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 16549 AURORA AVE N FL 3
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City | SHORELINE
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State | WA
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Zip | 98133-5308
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Country | US
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Telephone | 206-880-2144
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Fax | 206-866-9114
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Provider Business Mailing Address
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Address Line | PO BOX 3007
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City | SEATTLE
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State | WA
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Zip | 98114-3007
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Country | US
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Telephone | 206-880-2144
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Fax | 206-866-9114
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Authorized Official
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Title or Position | CFO
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Name | HERMES SHAHBAZIAN
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Credential |
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Telephone | 206-788-3618
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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