NPIMap

Organization Active NPI

Neighborcare Health-Rainier Beach Medical Clinic

  • Federally Qualified Health Center (FQHC)
  • Seattle, WA
National Provider Identifier
1104039320
Registry record updated Sep 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
NEIGHBORCARE HEALTH-RAINIER BEACH MEDICAL CLINIC
Practice address
9245 Rainier Ave S
Seattle, WA 98118-5569
Phone
(206) 722-8444
Fax
(206) 721-6310
NPI assigned
May 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2011

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

Authorized official

Name
Mark Lloyd Secord
Title
Executive Director
Phone
(206) 461-6935

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

9245 Rainier Ave S
Seattle, WA 98118-5569

Mailing address

905 Spruce St
Suite 300
Seattle, WA 98104-2474
Phone (206) 461-6935

Other identifiers 1

IdentifierTypeStateIssuer
7117062MedicaidWA

National Provider Directory

National Provider Directory
Tax ID family
Puget SND Neighbhd Heal75 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 18

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316390400000",
    "number": "1104039320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 SPRUCE ST",
            "address_2": "SUITE 300",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981042474",
            "telephone_number": "206-461-6935",
            "fax_number": "206-461-8382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9245 RAINIER AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981185569",
            "telephone_number": "206-722-8444",
            "fax_number": "206-721-6310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEIGHBORCARE HEALTH-RAINIER BEACH MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2011-09-19",
        "status": "A",
        "authorized_official_last_name": "SECORD",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "LLOYD",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "206-461-6935"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7117062",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2011; 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.