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General NPI Number Information
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NPI Number | 1912056870
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Entity Type | Organization
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Legal Business Name | HEALTHPOINT
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 04/21/2021
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Provider Practice Location Address
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Address Line | 955 POWELL AVE SW
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City | RENTON
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State | WA
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Zip | 98055-2908
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Country | US
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Telephone | 425-277-1311
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Fax | 425-277-1566
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Provider Business Mailing Address
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Address Line | 955 POWELL AVE SW
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City | RENTON
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State | WA
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Zip | 98055-2908
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Country | US
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Telephone | 425-277-1311
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Fax | 425-277-1566
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | MATT SPRAY
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Credential |
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Telephone | 425-277-1311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number | 600461511
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License Number State | WA
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