NPIMap

Organization Active NPI

Neighborcare Health

Doing business as Roosevelt Teen Health Dental

  • Federally Qualified Health Center (FQHC)
  • Seattle, WA
National Provider Identifier
1477807014
Registry record updated Nov 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
NEIGHBORCARE HEALTH
Doing business as
Roosevelt Teen Health Dental
Practice address
1410 NE 66TH St
Seattle, WA 98115-6744
Phone
(206) 527-8336
Fax
(206) 517-4195
NPI assigned
Nov 5, 2012
Last updated
Nov 5, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2012

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

Authorized official

Name
Mark Secord
Title
Ceo
Phone
(206) 548-3050

Specialties & licenses 1

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

Addresses

Primary practice location

1410 NE 66TH St
Seattle, WA 98115-6744

Mailing address

905 Spruce St Ste 300
Seattle, WA 98104-2474
Phone (206) 548-3114

Other names 1

  • Roosevelt Teen Health Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Puget Sound Neighborhood Health Centers75 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1352073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352073600000",
    "number": "1477807014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 SPRUCE ST STE 300",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981042474",
            "telephone_number": "206-548-3114",
            "fax_number": "206-762-6355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 NE 66TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981156744",
            "telephone_number": "206-527-8336",
            "fax_number": "206-517-4195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEIGHBORCARE HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-05",
        "last_updated": "2012-11-05",
        "status": "A",
        "authorized_official_last_name": "SECORD",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "206-548-3050"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Roosevelt Teen Health Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 5, 2012; 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.