Provider Demographics
NPI:1578596748
Name:HEALTHPOINT
Entity Type:Organization
Organization Name:HEALTHPOINT
Other - Org Name:HEALTHPOINT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:PENNETTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-203-0469
Mailing Address - Street 1:955 POWELL AVE SW
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-2908
Mailing Address - Country:US
Mailing Address - Phone:425-277-3111
Mailing Address - Fax:425-277-1566
Practice Address - Street 1:4424 S 188TH ST
Practice Address - Street 2:BUILDING #900 WEST DOOR
Practice Address - City:SEATAC
Practice Address - State:WA
Practice Address - Zip Code:98188-5028
Practice Address - Country:US
Practice Address - Phone:206-444-7746
Practice Address - Fax:206-444-7748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7136567Medicaid
WA000150900Medicare PIN
WA7136567Medicaid