Provider Demographics
NPI:1295383958
Name:KING COUNTY FINANCE
Entity Type:Organization
Organization Name:KING COUNTY FINANCE
Other - Org Name:KING COUNTY DEPT OF PUBLIC HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROVIDER ENROLLMENT SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:ARDELL
Authorized Official - Last Name:MOE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-263-8807
Mailing Address - Street 1:401 5TH AVE STE 1000
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-1818
Mailing Address - Country:US
Mailing Address - Phone:425-263-8414
Mailing Address - Fax:206-259-2751
Practice Address - Street 1:908 JEFFERSON ST FL 11
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2433
Practice Address - Country:US
Practice Address - Phone:206-744-3950
Practice Address - Fax:206-744-4151
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KING COUNTY FINANCE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-08-27
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)