Healthcare Provider Details
I. General information
NPI: 1861922387
Provider Name (Legal Business Name): SEA MAR COMMUNITY HEALTH CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/18/2017
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
31405 18TH AVE S
FEDERAL WAY WA
98003-5433
US
IV. Provider business mailing address
1040 S HENDERSON ST
SEATTLE WA
98108-4720
US
V. Phone/Fax
- Phone: 253-681-6630
- Fax: 253-681-6649
- Phone: 206-788-3220
- Fax: 206-788-3225
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0002X |
| Taxonomy | Clinic Pharmacy |
| License Number | PHAR.CF.60723236 |
| License Number State | WA |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROGELIO
RIOJAS
Title or Position: CEO
Credential:
Phone: 206-763-5277