Healthcare Provider Details

I. General information

NPI: 1750737193
Provider Name (Legal Business Name): SEA MAR COMMUNITY HEALTH CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2016
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2781 S 242ND ST
DES MOINES WA
98198-5166
US

IV. Provider business mailing address

1040 S HENDERSON ST
SEATTLE WA
98108-4720
US

V. Phone/Fax

Practice location:
  • Phone: 206-212-4530
  • Fax: 206-212-4535
Mailing address:
  • Phone: 206-788-3220
  • Fax: 206-788-3225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License NumberPHAR.CF.60610726
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ROGELIO RIOJAS
Title or Position: CEO/PRESIDENT
Credential:
Phone: 206-788-3273