Provider Demographics
NPI:1437979010
Name:COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTY
Entity type:Organization
Organization Name:COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REVENUE CYCLE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALISA
Authorized Official - Middle Name:
Authorized Official - Last Name:GIBSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-789-3700
Mailing Address - Street 1:8609 EVERGREEN WAY
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-2619
Mailing Address - Country:US
Mailing Address - Phone:452-789-3700
Mailing Address - Fax:
Practice Address - Street 1:21801 44TH AVE W
Practice Address - Street 2:
Practice Address - City:MOUNTLAKE TERRACE
Practice Address - State:WA
Practice Address - Zip Code:98043-3515
Practice Address - Country:US
Practice Address - Phone:425-835-5227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-16
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)