NPIMap

Organization Active NPI

Community Health Center of Snohomish County

  • Family Medicine Physician
  • Everett, WA
National Provider Identifier
1073720108
Registry record updated Jun 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
7034036 Issued in WA
Legal business name
COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTY
Practice address
5929 Evergreen Way
Everett, WA 98203-6031
Phone
(425) 789-3700
Fax
(425) 789-3754
NPI assigned
May 17, 2007
Organization subpart
Yes
Parent organization
COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 13, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kenneth M Green
Title
Executive Director
Phone
(425) 789-3700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 7034036 WA Primary

Addresses

Primary practice location

5929 Evergreen Way
Everett, WA 98203-6031

Mailing address

PO Box 13060
Everett, WA 98206-3060
Phone (425) 789-3700

Other identifiers 1

IdentifierTypeStateIssuer
7590227MedicaidWA

Other names 1

  • FQHC Enhancement Other name

National Provider Directory

National Provider Directory
Tax ID family
Community Health Center28 organizations share this tax ID, including this one
Part of
Community Health Center

Other organizations with this tax ID 27

Organizations that report the same tax identification number in the National Provider Directory.

View all 27

Locations

5929 Evergreen Way
Everett, WA 98203
Phone (360) 933-4892

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213315200000",
    "number": "1073720108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13060",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982063060",
            "telephone_number": "425-789-3700",
            "fax_number": "425-789-3754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5929 EVERGREEN WAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982036031",
            "telephone_number": "425-789-3700",
            "fax_number": "425-789-3754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTY",
        "enumeration_date": "2007-05-17",
        "last_updated": "2008-06-13",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "425-789-3700"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "7034036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7590227",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FQHC Enhancement",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.