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General NPI Number Information
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NPI Number | 1942358262
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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 | 01/05/2007
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Last Update Date | 01/31/2025
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Provider Practice Location Address
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Address Line | 8915 14TH AVE S FL 2
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City | SEATTLE
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State | WA
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Zip | 98108-4813
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Country | US
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Telephone | 206-762-3263
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Fax | 206-763-6574
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Provider Business Mailing Address
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Address Line | PO BOX 34703
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City | SEATTLE
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State | WA
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Zip | 98124-1703
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DEPUTY DIRECTOR
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Name | MARY BARTOLO
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Credential |
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Telephone | 206-788-3224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 122400000X
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Taxonomy Name | Denturist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number | 6005372781
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License Number State | WA
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