MEDICARE: HOPECENTRAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1326385451
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOPECENTRAL

Provider Business Mailing Address
First Line	:	3826 S OTHELLO ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98118-3562
Country	:	US
Telephone Number	:	206-455-9845
Fax Number	:	206-723-1701

Provider Business Practice Location Address
First Line	:	3826 S OTHELLO ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98118-3562
Country	:	US
Telephone Number	:	206-455-9845
Fax Number	:	206-723-1701

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	DAVID KWOK
Credential	:
Telephone Number	:	206-745-0168

Provider Enumeration Date	:	01/09/2013
Last Update Date	:	09/21/2016

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Directions to “HOPECENTRAL ” Practice Location

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