Provider Demographics
NPI:1316340516
Name:ALIANCE COMMUNITY HEALTH SERVICE NETWORK
Entity type:Organization
Organization Name:ALIANCE COMMUNITY HEALTH SERVICE NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:AYELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-653-7917
Mailing Address - Street 1:16005 INTL BLVD
Mailing Address - Street 2:A
Mailing Address - City:SEATAC
Mailing Address - State:WA
Mailing Address - Zip Code:98188-2651
Mailing Address - Country:US
Mailing Address - Phone:206-653-7917
Mailing Address - Fax:206-653-7300
Practice Address - Street 1:16005 INTL BLVD
Practice Address - Street 2:A
Practice Address - City:SEATAC
Practice Address - State:WA
Practice Address - Zip Code:98188-2651
Practice Address - Country:US
Practice Address - Phone:206-653-7917
Practice Address - Fax:206-653-7300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-01
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA603294323261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care