ICHS HOLLY PARK PHARMACY
NPI 1508990631
Pharmacy - Community/Retail Pharmacy in Seattle, WA

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

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Active since March 14, 2007

3815 S OTHELLO ST FL 2, SEATTLE, WA 98118(206) 788-3563(206) 788-2369 Get Directions Write a Review

NPPES record last updated: January 26, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Ichs Holly Park Pharmacy NPPES

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

ICHS HOLLY PARK PHARMACY (NPI 1508990631) is a healthcare organization registered as a community/retail pharmacy 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

NPI1508990631

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameINTERNATIONAL COMMUNITY HEALTH SERVICES

Location Address3815 S OTHELLO ST FL 2Seattle, WA 98118-3510

Mailing Address3815 S Othello St Fl 2Seattle, WA 98118-3510 · (206) 788-3563 · Fax (206) 788-2369

Phone(206) 788-3563

Fax(206) 788-2369

Organization SubpartNo

Authorized OfficialHermes ShahbazianCfo · (206) 788-3618

Enumeration DateMarch 14, 2007

Last NPPES UpdateJanuary 26, 2021

NPPES CertifiedJanuary 26, 2021

✔ NPI 1508990631 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers

Taxonomy Code3336C0003X

License✔ Licensed in WA · CF00058776

Definition

A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

3815 S OTHELLO ST FL 2, Seattle, WA 98118

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Other Names 1

Doing Business AsIchs Holly Park Pharmacy

Other Identifiers 1

Medicaid6029540WA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arkansas Health & Wellness and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ichs Holly Park Pharmacy is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by October 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date

StateWashingtonEnrollment IDO20210129000988Non-DME Part B · Mass Immunization (Roster Biller Only)Due dateOctober 31, 2026

Source: CMS Revalidation Due Date List, October 2026 release.

Other Providers at the Same Location NPPES 10

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

HELEN LOUIE PHARM. D.

Pharmacist