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NPI 1114113602

NPI 1114113602 : SEA MAR COMMUNITY HEALTH CENTERS : OLYMPIA, WA

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General NPI Number Information
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    NPI Number           |    1114113602
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    Entity Type          |    Organization 
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    Legal Business Name  |    SEA MAR COMMUNITY HEALTH CENTERS 
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Dates
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    Enumeration Date     |    09/19/2007
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    Last Update Date     |    06/17/2025
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Provider Practice Location Address
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    Address Line         |    3030 LIMITED LN NW 
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    City                 |    OLYMPIA
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    State                |    WA
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    Zip                  |    98502-2704
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    Country              |    US
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    Telephone            |    360-704-7575
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    Fax                  |    360-704-7579
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Provider Business Mailing Address
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    Address Line         |    1040 S HENDERSON ST 
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    City                 |    SEATTLE
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    State                |    WA
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    Zip                  |    98108-4720
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    Country              |    US
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    Telephone            |    206-788-3220
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    Fax                  |    206-788-3225
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Authorized Official
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    Title or Position    |    EXECUTIVE VICE PRESIDENT
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    Name                 |     MARY  BARTOLO 
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    Credential           |    
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    Telephone            |    206-763-5277
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    333600000X
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    Taxonomy Name        |    Pharmacy
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    3336C0002X
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    Taxonomy Name        |    Clinic Pharmacy
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    3336C0003X
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    Taxonomy Name        |    Community/Retail Pharmacy
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    License Number       |    CF59039
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    License Number State |    WA
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