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RWI98032 UTOPIA Washington (Terminated)
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Main Details
Name
UTOPIA Washington
Subdivision Name
Mapu Maia Clinic
Type
Ryan White Part A
340B ID
RWI98032
Grant Number
H89HA00022
Additional Details
Current Program Status
Terminated
Registration Date
7/3/2024
Participating Start Date
10/1/2024
Participating Approval Date
8/26/2024
Last Recertification Date
Time Period the Assistance was Received
3/1/2023 - 3/1/2025
Termination Date
Termination Reason
4/1/2025
Failure to recertify
Contacts
Authorizing Official
UTOPIA Washington
Tepatasi Vaina, Ms.
(206) 653-1941
Primary Contact
UTOPIA WA / Mapu Maia Clinic
Callie Naholowaa, Clinical Operations
(206) 774-9746
Addresses
Street Address
812 Central Ave N
Kent, WA 98032
Billing Address
UTOPIA WA
841 Central Ave N
Suite C-106
Kent, WA 98032
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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Participating from effective date: (10/01/2023) until terminated effective date: (04/01/2024); reinstatement effective date: (10/1/2024)
08/06/2024
May 2025
May 2025
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