Healthcare Provider Details
I. General information
NPI: 1407325368
Provider Name (Legal Business Name): SEA MAR COMMUNITY HEALTH CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/20/2018
Last Update Date: 02/03/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2203 OLD HWY 99 S
MOUNT VERNON WA
98273-9009
US
IV. Provider business mailing address
PO BOX 34703
SEATTLE WA
98124-1703
US
V. Phone/Fax
- Phone: 360-542-8810
- Fax: 360-542-8811
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QF0400X |
| Taxonomy | Federally Qualified Health Center (FQHC) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROGELIO
RIOJAS
Title or Position: CEO
Credential:
Phone: 206-763-5277