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NPI Code Detail

MEDICARE: SEA MAR COMMUNITY HEALTH CENTERS

MEDICARE: SEA MAR COMMUNITY HEALTH CENTERS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist
21223G0001XGeneral Practice Dentistry
31223P0221XPediatric Dentistry
4124Q00000XDental Hygienist
5261QF0400XFederally Qualified Health Center (FQHC)6005372781WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538217500
Entity Type Code : Organization
Provider Name (Legal Business Name) : SEA MAR COMMUNITY HEALTH CENTERS
Provider Business Mailing Address
First Line : PO BOX 34703
Second Line :
City : SEATTLE
State : WA
Zip : 98124-1703
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1400 N LAVENTURE RD
Second Line :
City : MOUNT VERNON
State : WA
Zip : 98273-2766
Country : US
Telephone Number : 360-542-8901
Fax Number : 360-542-8790
Authorized Official
Title or Position : EXECUTIVE VICE PRESIDENT
Name : MARY BARTOLO
Credential :
Telephone Number : 206-788-3224
Provider Enumeration Date : 01/08/2007
Last Update Date : 01/31/2025

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Practice Location Address:
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98273-2766
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1891871596 — ANNE MARIE WELLS RDH
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1528115870 — SEA MAR COMMUNITY HEALTH CENTERS
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Practice Fax: 360-542-8796
1336291830 — DIANE M KAPLAN MD
Practice Location Address:
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98273-2766
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1144372632 — BEN M WINKES MD
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1400 N LAVENTURE RD
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1538211016 — ELLEN M RAK MD
Practice Location Address:
1400 N LAVENTURE RD
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Practice Phone: 605-428-9003
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Directions to “SEA MAR COMMUNITY HEALTH CENTERS ” Practice Location

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