| Odessa Brown Children's Clinic | |
|
2101 E Yesler Way Suite 100 Seattle WA 98122-5959 | |
| (206) 987-7200 | |
| (206) 987-7206 |
| Full Name | Odessa Brown Children's Clinic |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2101 E Yesler Way, Seattle, Washington |
| Authorized Official Name and Position | Suzanne Beitel (SVP AND CFO) |
| Authorized Official Contact | 2069872004 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Odessa Brown Children's Clinic Po Box 5371 Rc-504 Seattle WA 98145-5020 Ph: (206) 987-5770 | Odessa Brown Children's Clinic 2101 E Yesler Way Suite 100 Seattle WA 98122-5959 Ph: (206) 987-7200 |
| NPI Number | 1023140431 |
|---|---|
| Provider Enumeration Date | 03/12/2007 |
| Last Update Date | 09/28/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023140431 | NPI | - | NPPES |
| 5707005 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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