NPIMap

Organization Active NPI

International Community Health Services

Doing business as ICHS at Sound Auburn

  • Federally Qualified Health Center (FQHC)
  • Auburn, WA
National Provider Identifier
1831910439
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
INTERNATIONAL COMMUNITY HEALTH SERVICES
Doing business as
ICHS at Sound Auburn
Practice address
4238 Auburn Way N
Auburn, WA 98002-1311
Phone
(253) 444-0106
NPI assigned
Oct 17, 2024
Last updated
Oct 17, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
INTERNATIONAL COMMUNITY HEALTH SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Authorized official

Name
Hermes Shahbazian
Title
Chief Financial Officer
Phone
(206) 788-3618

Specialties & licenses 1

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

Addresses

Primary practice location

4238 Auburn Way N
Auburn, WA 98002-1311

Mailing address

PO Box 3007
Seattle, WA 98114-3007
Phone (253) 444-0106

Other names 1

  • ICHS at Sound Auburn Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040301000204 WA Part B Supplier - Clinic/Group Practice 5799695672 Receives reassigned benefits from 130 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bellevue, WA; Seattle, WA; Shoreline, WA; Auburn, WA
O20251030000788 WA Part A Provider - Federally Qualified Health Center (FQHC) 5799695672 Practice locations: Auburn, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1831910439. Details of each certification follow.

Federally qualified health center certification: CCN 501074

Legal name
INTERNATIONAL COMMUNITY HEALTH SERVICES
Doing business as
ICHS SOUND AUBURN MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 22, 2025
Last certification
Aug 22, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
4238 Auburn Way N
Auburn, WA 98002-1311

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 6

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2327326Ichs at Sound Auburn4238 Auburn Way N, Auburn, WA 98002Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory
Tax ID family
International District33 organizations share this tax ID, including this one
Part of
International District

Other organizations with this tax ID 31

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

View all 31

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1050 140th Ave NE
Bellevue, WA 98005
Phone (425) 373-3000

3815 S Othello St
#2
Seattle, WA 98118
Phone (206) 788-3500

7116 MLK Jr Way S
Seattle, WA 98118
Phone (206) 461-4948

720 8th Ave S
Ste 10
Seattle, WA 98104
Phone (206) 461-3235

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Mariam Abarientos Individual Corporate DirectorVolunteer Board Director Mar 22, 2017
Hermes Shahbzian Individual Corporate OfficerCfo May 16, 1994
W-2 Managing EmployeeCfo May 6, 1994
Catherine Johnson Individual Corporate Director Jul 25, 2012
Gildas Cheung Individual Corporate DirectorVolunteer Board Director Jan 28, 2009
John Foz Individual Corporate DirectorVolunteer Board Director Sep 24, 2008
International Community Health Services Organization, Seattle, WA Corporation, Non-profit, Chain home office 5% Or Greater Direct Ownership Interest May 1, 2025 100%
Operational/Managerial Control May 1, 2025 100%
Chengzhen Dai Individual Corporate DirectorVolunteer Board Director May 27, 2020
Kelli Nomura Individual Corporate OfficerCeo Nov 7, 2022
W-2 Managing Employee Nov 7, 2022

Owners & managing parties with NPI records 6

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

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Ichs Bellevue Medical and Dental ClinicBellevue, WA, CCN 501971 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 May 1, 2014
May 1, 2014
Ichs Shoreline Medical and Dental ClinicShoreline, WA, CCN 501974 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Sep 15, 2014
Sep 15, 2014
Ichs International District Vision ClinicSeattle, WA, CCN 941034 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Sep 15, 2017
Sep 15, 2017

Owned or controlled facilities with NPI records 3

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

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 229

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 229

NPI Registry JSON

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

{
    "created_epoch": "1729123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729123200000",
    "number": "1831910439",
    "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",
            "telephone_number": "253-444-0106",
            "fax_number": "253-733-0893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4238 AUBURN WAY N",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980021311",
            "telephone_number": "253-444-0106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNATIONAL COMMUNITY HEALTH SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INTERNATIONAL COMMUNITY HEALTH SERVICES",
        "enumeration_date": "2024-10-17",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A",
        "authorized_official_last_name": "SHAHBAZIAN",
        "authorized_official_first_name": "HERMES",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "206-788-3618"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ICHS at Sound Auburn",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Auburn, WA

Sources for this page

Verify at the official NPI Registry.