NPIMap

Organization Active NPI

International Community Health Services

  • Clinical Psychologist
  • Seattle, WA
National Provider Identifier
1679765259
Registry record updated Aug 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
INTERNATIONAL COMMUNITY HEALTH SERVICES
Practice address
720 8TH Ave S
Suite 100
Seattle, WA 98104-3032
Phone
(206) 788-3700
Fax
(206) 788-3706
NPI assigned
Aug 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2007

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

Authorized official

Name
Ms. Peggy Phung
Title
Assistant Finance Manager
Phone
(206) 788-3605

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

720 8TH Ave S
Suite 100
Seattle, WA 98104-3032

Mailing address

PO Box 3007
Seattle, WA 98114-3007

Other identifiers 1

IdentifierTypeStateIssuer
7137862MedicaidWA

Other names 1

  • International District Clinic Other name

National Provider Directory

National Provider Directory
Tax ID family
International Community Health Services33 organizations share this tax ID, including this one

Other organizations with this tax ID 31

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

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187222400000",
    "number": "1679765259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3007",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981143007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 8TH AVE S",
            "address_2": "SUITE 100",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981043032",
            "telephone_number": "206-788-3700",
            "fax_number": "206-788-3706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNATIONAL COMMUNITY HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-16",
        "last_updated": "2007-08-16",
        "status": "A",
        "authorized_official_last_name": "PHUNG",
        "authorized_official_first_name": "PEGGY",
        "authorized_official_title_or_position": "ASSISTANT FINANCE MANAGER",
        "authorized_official_telephone_number": "206-788-3605",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7137862",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "International District Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Aug 16, 2007; 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.