HOLLY PARK MEDICAL & DENTAL CLINIC
NPI 1275657819
Registered Nurse - Community Health in Seattle, WA

Q: What is the provider's specialty?

The provider's specialty is Registered Nurse with taxonomy code 163WC1500X and a focus in Community Health.

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: March 29, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Mar 29, 2021, Jan 26, 2021 (2 updates tracked since 2021).

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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 1275657819) is a healthcare organization registered as a community health in Seattle, Washington and active in the NPI registry since March 2007. The organization lists Hermes Shahbazian, Cfo, as its authorized official.

NPPES Registry Identity

NPI1275657819

Entity TypeOrganization

Primary Taxonomy163WC1500X

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 OfficialHermes ShahbazianCfo · (206) 788-3618

Enumeration DateMarch 19, 2007

Last NPPES UpdateMarch 29, 20212 updates tracked since enumeration

NPPES CertifiedMarch 29, 2021

✔ NPI 1275657819 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRegistered Nurse · Community HealthNursing Service Providers

Taxonomy Code163WC1500X

3815 S OTHELLO ST, Seattle, WA 98118

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Other Names 1

Other NameHolly Park Medical & Dental Clinic

Other Identifiers 1

Medicaid7408479WA

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