HOLLY PARK MEDICAL & DENTAL CLINIC
NPI 1104940733
Family Medicine in Seattle, WA

Q: What is International Community Health Services's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since March 19, 2007

3815 S OTHELLO ST, 2ND FLOOR, SEATTLE, WA 98118(206) 788-3500(206) 788-3521 Get Directions Write a Review

NPPES record last updated: December 20, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Holly Park Medical & Dental Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HOLLY PARK MEDICAL & DENTAL CLINIC (NPI 1104940733) is a healthcare organization registered as a family medicine in Seattle, Washington and active in the NPI registry since March 2007. The organization lists Peggy Phung, Assistant Finance Manager, as its authorized official.

NPPES Registry Identity

NPI1104940733

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameINTERNATIONAL COMMUNITY HEALTH SERVICES

Location Address3815 S OTHELLO ST, 2ND FLOORSeattle, WA 98118-3510

Mailing AddressPo Box 24911Seattle, WA 98124-0911 · (206) 788-3600 · Fax (206) 652-5216

Phone(206) 788-3500

Fax(206) 788-3521

Organization SubpartYes

Authorized OfficialPeggy PhungAssistant Finance Manager · (206) 788-3605

Enumeration DateMarch 19, 2007

Last NPPES UpdateDecember 20, 2007

✔ NPI 1104940733 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

3815 S OTHELLO ST, Seattle, WA 98118

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Other Names 1

Other NameHolly Park Medical & Dental Clinic

Other Identifiers 1

Medicaid7900012WA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JESSICA TO DNP, ARNP, FNP-BC

Nurse Practitioner (Family)