Healthcare Provider Details
I. General information
NPI: 1255803599
Provider Name (Legal Business Name): SEA MAR COMMUNITY HEALTH CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/27/2018
Last Update Date: 01/31/2025
Certification Date: 01/31/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9650 15TH AVE SW
SEATTLE WA
98106-2576
US
IV. Provider business mailing address
PO BOX 34703
SEATTLE WA
98124-1703
US
V. Phone/Fax
- Phone: 206-965-1055
- Fax: 206-965-1032
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QF0400X |
| Taxonomy | Federally Qualified Health Center (FQHC) |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QR0405X |
| Taxonomy | Substance Use Disorder Rehabilitation Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROGELIO
RIOJAS
Title or Position: CEO
Credential:
Phone: 206-763-5277