NPIMap

Community Health Center of Snohomish County

Organization Active NPI Federally Qualified Health Center (FQHC) · Everett, WA

NPI 1730136367 · NPPES record last updated Mar 25, 2016

Key facts

NPI
1730136367
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTY
Practice address
8609 Evergreen Way
Everett, WA 98208-2619
Phone
(425) 789-1000
Fax
(425) 789-3750
NPI assigned
May 28, 2006
Organization subpart
No

Authorized official

Name
Mr. Robert C Farrell
Title
Executive Director
Phone
(425) 789-3700

Other NPIs with the same Medicare PAC ID 17

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

Practitioners 237

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

View all 237

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040123000395 WA Part B Supplier - Clinic/Group Practice 0446152003 Receives reassigned benefits from 234 practitioners
Practice locations: Everett, WA; Lynnwood, WA; Edmonds, WA; Arlington, WA

National Provider Directory

Locations

23525 84th Ave W
Edmonds, WA 98026

6002 168th St SW
Bldg B
Lynnwood, WA 98037

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 207Q00000X 7034036 WA
Federally Qualified Health Center (FQHC) 261QF0400X Yes

Addresses

Primary practice location

8609 Evergreen Way
Everett, WA 98208-2619

Mailing address

8609 Evergreen Way
Everett, WA 98208-2619
Phone (425) 789-3700

Other identifiers

IdentifierTypeStateIssuer
1017523MedicaidWA
2001689MedicaidWA

Other names

  • CHC of Snohomish County Other name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 25, 2016.

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458864000000",
    "number": "1730136367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8609 EVERGREEN WAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982082619",
            "telephone_number": "425-789-3700",
            "fax_number": "425-789-3750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8609 EVERGREEN WAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982082619",
            "telephone_number": "425-789-1000",
            "fax_number": "425-789-3750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2016-03-25",
        "status": "A",
        "authorized_official_last_name": "FARRELL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "425-789-3700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "7034036",
            "primary": false
        },
        {
            "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": "1017523",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2001689",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHC of Snohomish County",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Everett, WA

All providers in Everett, WA · Federally Qualified Health Center (FQHC) in Washington

Sources for this page

Verify at the official NPI Registry.