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King County Finance

Organization Active NPI Multi-Specialty Clinic/Center · Seattle, WA

NPI 1306903604 · NPPES record last updated Mar 24, 2016

Key facts

NPI
1306903604
Entity type
Organization (NPI type 2)
Primary specialty
Multi-Specialty Clinic/Center 261QM1300X
Legal business name
KING COUNTY FINANCE
Practice address
401 5TH Ave
Suite 1200
Seattle, WA 98104-1818
Phone
(206) 205-5975
NPI assigned
Jan 3, 2007
Organization subpart
Yes
Parent organization (as reported)
KING COUNTY FINANCE

Authorized official

Name
Maureen Peterson
Title
Administrative & Financial Services
Phone
(206) 263-8392

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Practitioners 98

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 98

Medicare participation

Medicare fee-for-service enrollment
Enrolled (4 enrollments) in WA

Federally qualified health center certification: CCN 941014

Legal name
KING COUNTY FINANCE
Doing business as
PUBLIC HEALTH - SEATTLE & KING COUNTY
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 28, 2016
Last certification
Jul 28, 2016
Ownership / control type
Non-profit – corporation
Organization structure
Government · Non-profit
Enrollment address
14350 SE Eastgate Way
Bellevue, WA 98007-6458

Federally qualified health center certification: CCN 941015

Legal name
KING COUNTY FINANCE
Doing business as
PUBLIC HEALTH - SEATTLE & KING COUNTY
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 28, 2016
Last certification
Jul 28, 2016
Ownership / control type
Non-profit – corporation
Organization structure
Government · Non-profit
Enrollment address
2124 4TH Ave
Seattle, WA 98121-2308

Federally qualified health center certification: CCN 941016

Legal name
KING COUNTY FINANCE
Doing business as
KING COUNTY DEPT OF PUBLIC HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 12, 2016
Last certification
Oct 12, 2016
Ownership / control type
Non-profit – corporation
Organization structure
Government · Non-profit
Enrollment address
908 Jefferson St
FL 11
Seattle, WA 98104-2433

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Maureen Peterson
Individual 		Corporate Officer Jan 24, 2011 100%
Operational/Managerial Control
Finance & Administrative Service		 Jan 24, 2011 100%
Corporate Officer
100		 Jan 24, 2011
Corporate Director
Operational & Finance Manager		 Jan 24, 2011 100%
Operational/Managerial Control
Operational & Finance Manager		 Jan 24, 2011 100%
King County Finance
Organization · Seattle, WA 		5% Or Greater Direct Ownership Interest Jul 20, 2016 100%
5% Or Greater Direct Ownership Interest Jan 24, 2011 100%

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Public Health - Seattle & King County
Bellevue, WA · CCN 941014		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 20, 2016
Public Health - Seattle & King County
Seattle, WA · CCN 941015		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 20, 2016
King County Dept of Public Health
Seattle, WA · CCN 941016		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 24, 2011

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20031204001111 WA Part B Supplier - Clinic/Group Practice 8022913789 Receives reassigned benefits from 97 practitioners
1 other NPI on this enrollment
Practice locations: Renton, WA; Seatte, WA; Seattle, WA; Burien, WA; Kent, WA; Auburn, WA; Bellevue, WA; Bothell, WA…
O20160921000702 WA Part a Provider - Federally Qualified Health Center (FQHC) 8022913789 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bellevue, WA
O20160921000868 WA Part a Provider - Federally Qualified Health Center (FQHC) 8022913789 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Seattle, WA
O20161107001885 WA Part a Provider - Federally Qualified Health Center (FQHC) 8022913789 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Seattle, WA

National Provider Directory

Part of
Seattle King Co Dept of Public Health

Locations

14350 SE Eastgate Way
Bellevue, WA 98007
Phone (206) 296-9754

25742 104th Ave SE
Kent, WA 98030
Phone (206) 263-0540

401 5th Ave
Ste 1000
Seattle, WA 98104
Phone (206) 263-8298

5511 15th Ave S
Seattle, WA 98108
Phone (206) 263-2489

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Yes

Addresses

Primary practice location

401 5TH Ave
Suite 1200
Seattle, WA 98104-1818

Mailing address

401 Fifth Avenue
Suite 1300
Seattle, WA 98104-1818
Phone (206) 205-5975

Other names

  • Seattle-King County Dept of Public Health Doing business as

Other providers in Seattle, WA

All providers in Seattle, WA · Multi-Specialty Clinic/Center in Washington

Sources for this page

Verify at the official NPI Registry.