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1700101797 NPI number — SEA MAR COMMUNITY HEALTH CENTERS

NPI Number: 1700101797
Health Care Provider/Practitioner: SEA MAR COMMUNITY HEALTH CENTERS

Information about “1700101797” NPI (SEA MAR COMMUNITY HEALTH CENTERS) exists in 1700101797 in HTML format HTML  |  1700101797 in plain Text format TXT  |  1700101797 in PDF (Portable Document Format) PDF  |  1700101797 in an XML format XML  formats.

NPI Number : 1700101797 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1700101797",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "SEA MAR COMMUNITY HEALTH CENTERS",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 34703",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SEATTLE",
    "MailingAddressStateName": "WA",
    "MailingAddressPostalCode": "98124-1703",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "669 WOODLAND SQUARE LOOP SE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LACEY",
    "PracticeLocationAddressStateName": "WA",
    "PracticeLocationAddressPostalCode": "98503-1038",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "360-359-4840",
    "PracticeLocationAddressFaxNumber": "360-359-4850",
    "EnumerationDate": "04/01/2010",
    "LastUpdateDate": "02/26/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "BARTOLO",
    "AuthorizedOfficialFirstName": "MARY",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "EXECUTIVE VICE PRESIDENT",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "206-763-5277",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "174H00000X",
          "TaxonomyName": "Health Educator",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207Q00000X",
          "TaxonomyName": "Family Medicine Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QF0400X",
          "TaxonomyName": "Federally Qualified Health Center (FQHC)",
          "LicenseNumber": "600 537 278 1",
          "LicenseNumberStateCode": "WA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

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