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General NPI Number Information
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NPI Number | 1881514792
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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 | 07/20/2026
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Last Update Date | 07/20/2026
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Provider Practice Location Address
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Address Line | 3826 S OTHELLO ST
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City | SEATTLE
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State | WA
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Zip | 98118-3562
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Country | US
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Telephone | 206-788-3613
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Fax |
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Provider Business Mailing Address
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Address Line | 720 8TH AVE S
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City | SEATTLE
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State | WA
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Zip | 98104-3006
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Country | US
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Telephone | 206-788-3605
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Fax |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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