SEATTLE INDIAN HEALTH BOARD (NPI# 1245378298) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245378298 |
| Entity Type | Organization |
| Organization Name | SEATTLE INDIAN HEALTH BOARD |
| Practice Address |
611 12th Ave S Seattle WA 98144-1910 |
| Practice Telephone | 2063249360 |
| Practice Fax Number | 2063248910 |
| Mailing Telephone | 2063249360 |
| Mailing Fax Number | 2063248910 |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2015-05-12 |
| Authorized Official Name | MR. RALPH FORQUERA (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 2063249360 |
| Authorized Official Credential | MPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
600440936 | WA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 6008973 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235778812 | Seattle Indian Health Board | Clinic/Center | 410 2nd Avenue Ext S, Seattle, WA 98104-2876 | 2019-12-31 |
| 1215002365 | Seattle Indian Health Board | Substance Abuse Rehabilitation Facility | 9236 Renton Ave S, Seattle, WA 98118-5322 | 2006-11-22 |
| 1437297488 | Seattle Indian Health Board | Clinic/Center | 611 12th Ave S, Seattle, WA 98144-1910 | 2007-02-02 |
| 1326186370 | Seattle Indian Health Board | Clinic/Center | 611 12th Ave S, 200, Seattle, WA 98144-1910 | 2007-02-02 |
| 1154469104 | Seattle Indian Health Board | Clinic/Center | 611 12th Ave S, Seattle, WA 98144-1910 | 2007-02-02 |
| 1497820542 | Seattle Indian Health Board | Clinic/Center | 611 12th Ave S, Seattle, WA 98144-1910 | 2006-11-22 |
| 1306911458 | Seattle Indian Health Board | Clinic/Center | 611 12th Ave S, Suite 200, Seattle, WA 98144-1910 | 2006-11-22 |
| 1316012461 | Seattle Indian Health Board | Clinic/Center | 611 12th Ave S, Seattle, WA 98144-1910 | 2006-11-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SEATTLE INDIAN HEALTH BOARD | 611 12th Ave S, Seattle, WA 98144-1910 |
| Washington State Corporations | SEATTLE INDIAN HEALTH BOARD FOUNDATION | 606 12th Ave S, Seattle, WA 98114 |
| Street Address |
611 12TH AVE S |
| City | SEATTLE |
| State | WA |
| Zip Code | 98144-1910 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598743106 | Debra Martha Fischer | Nurse Practitioner | 611 12th Ave S, Seattle, WA 98144-1910 | 2006-01-04 |
| 1336773951 | Korlette Karmell Bird | Counselor | 611 12th Ave S, Seattle, WA 98144-2007 | 2020-02-24 |
| 1902430424 | Krista Denise Hanley | Counselor | 611 12th Ave S, Seattle, WA 98144-2007 | 2020-02-24 |
| 1205300316 | David Gehlbach-wilson | Counselor | 611 12th Ave S, Seattle, WA 98144-2007 | 2019-01-11 |
| 1942770409 | Kelly Leonora Russell | Counselor | 611 12th Ave S, Seattle, WA 98144-2007 | 2018-11-27 |
| 1689143836 | Jeffrey Lane Mitchell | Counselor | 611 12th Ave S, Seattle, WA 98144-2007 | 2018-11-16 |
| 1033688288 | Roberta L Fletcher | Counselor | 611 12th Ave S, Seattle, WA 98144-2007 | 2018-11-16 |
| 1932674074 | Sarah Yankton Hill | Dentist | 611 12th Ave S, Seattle, WA 98144-2007 | 2018-10-04 |
| 1053894519 | Colleen Olivia D'amico | Pharmacist | 611 12th Ave S, Seattle, WA 98144 | 2018-09-11 |
| 1760994370 | Melinda Garay | Registered Nurse | 611 12th Ave S, Seattle, WA 98144-2007 | 2017-11-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558975235 | Miranda Plummer | Counselor | 2122 S Jackson Street, Seattle, WA 98144 | 2020-09-01 |
| 1891337457 | Alyson Paris | Counselor | 2100 24th Ave S, Suite 260, Seattle, WA 98144 | 2019-10-15 |
| 1912558370 | Marco Antonio Medina Sotelo | Counselor | 113 23rd Avenue South, Seattle, WA 98144 | 2019-09-26 |
| 1952865909 | John Thomas Hogan | Counselor | 1600 S Lane, Seattle, WA 98144 | 2019-01-23 |
| 1134693856 | Kimo Martin | Peer Specialist | 1600 Lane St, Seattle, WA 98144 | 2019-01-15 |
| 1952875791 | Rainier Chiropractic Accident and Injury Ps | Massage Therapist | 2326 Rainier Ave S, Ste B, Seattle, WA 98144 | 2019-01-15 |
| 1174097083 | Seann M Combs | Counselor | 1600 S Lane St, Seattle, Wa 98144, Seattle, WA 98144 | 2019-01-14 |
| 1922571587 | Cristina Wirkala | Registered Nurse | Crisis Solutions Center, 1600 South Lane Street, Seattle, WA 98144 | 2019-01-07 |
| 1215405162 | Vickie Barron | Counselor | 3401 Rainier Ave S, Suite B, Seattle, WA 98144 | 2018-11-08 |
| 1164906509 | Julie Seddon Cabell | Counselor | Central Youth and Family Services, 1901 Mlk Jr Way S., Seattle, WA 98144 | 2018-09-21 |
| Find all providers in zip 98144 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235778812 | Seattle Indian Health Board | Clinic/Center | 410 2nd Avenue Ext S, Seattle, WA 98104-2876 | 2019-12-31 |
| 1376185694 | Neighborcare Health | Clinic/Center | 2709 3rd Ave, Seattle, WA 98121-1217 | 2019-10-09 |
| 1295383958 | King County Finance | Clinic/Center | 908 Jefferson St Fl 11, Seattle, WA 98104-2433 | 2019-08-27 |
| 1881254449 | Neighborcare Health | Clinic/Center | 7101 62nd Ave Ne Ste 4, Seattle, WA 98115-7168 | 2019-06-17 |
| 1578028866 | Neighborcare Health | Clinic/Center | 2119 3rd Ave, Seattle, WA 98121-2333 | 2019-01-31 |
| 1073030508 | Neighborcare Health | Clinic/Center | 509 3rd Ave, Seattle, WA 98104-3282 | 2017-08-25 |
| 1144629908 | Neighborcare Health | Clinic/Center | 13555 Aurora Ave N, Seattle, WA 98133-7511 | 2014-08-18 |
| 1225461908 | Neighborcare Health | Clinic/Center | 2820 S Orcas St, Seattle, WA 98108-3066 | 2013-08-16 |
| 1184057150 | Neighborcare Health | Clinic/Center | 6760 34th Ave Sw, Seattle, WA 98126-4208 | 2013-08-14 |
| 1679825988 | Neighborcare Health | Clinic/Center | 7740 34th Ave Sw, Seattle, WA 98126-3503 | 2012-10-10 |
| Find all providers in SEATTLE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.