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NPI Code Detail

MEDICARE: SEA MAR COMMUNITY HEALTH CENTERS

MEDICARE: SEA MAR COMMUNITY HEALTH CENTERS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian
2207Q00000XFamily Medicine Physician
3207QA0000XAdolescent Medicine (Family Medicine) Physician
4207QA0401XAddiction Medicine (Family Medicine) Physician
5207QG0300XGeriatric Medicine (Family Medicine) Physician
6207QS0010XSports Medicine (Family Medicine) Physician
7208000000XPediatrics Physician
82080A0000XPediatric Adolescent Medicine Physician
92080N0001XNeonatal-Perinatal Medicine Physician
102080P0201XPediatric Allergy/Immunology Physician
112080P0203XPediatric Critical Care Medicine Physician
122080P0208XPediatric Infectious Diseases Physician
13363A00000XPhysician Assistant
14363L00000XNurse Practitioner
15261QF0400XFederally Qualified Health Center (FQHC)600537278WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578610911
Entity Type Code : Organization
Provider Name (Legal Business Name) : SEA MAR COMMUNITY HEALTH CENTERS
Provider Business Mailing Address
First Line : PO BOX 34703
Second Line :
City : SEATTLE
State : WA
Zip : 98124-1703
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9710 STATE AVE
Second Line :
City : MARYSVILLE
State : WA
Zip : 98270-2232
Country : US
Telephone Number : 360-653-1742
Fax Number : 360-657-3095
Authorized Official
Title or Position : EXECUTIVE VICE PRESIDENT
Name : MARY E BARTOLO
Credential :
Telephone Number : 206-763-5277
Provider Enumeration Date : 01/05/2007
Last Update Date : 02/26/2025

Similar Medicare Providers

1518895135 — HERNAN HUMBERTO ALVARADO ORELLANA MD
Practice Location Address:
9710 STATE AVE
MARYSVILLE, WA
98270-2232
Practice Phone: 360-653-1742
Practice Fax:
1821174517 — NATASHA HABIB DDS
Practice Location Address:
9710 STATE AVE
MARYSVILLE, WA
98270-2232
Practice Phone: 360-653-1742
Practice Fax: 360-653-2099
1982756128 — GREG STEPHEN SANDERS MD
Practice Location Address:
9710 STATE AVE
MARYSVILLE, WA
98270-2232
Practice Phone: 360-653-1742
Practice Fax: 360-653-2099
1114079357 — DR. JOYCE RAMOS NUESCA MD
Practice Location Address:
9710 STATE AVE
MARYSVILLE, WA
98270-2232
Practice Phone: 360-653-1742
Practice Fax: 360-653-2099
1801948039 — EVANGELINE VIOLA ERSKINE MD
Practice Location Address:
9710 STATE AVE
MARYSVILLE, WA
98270-2232
Practice Phone: 360-653-1742
Practice Fax: 360-653-2099
1659417699 — SEA-MAR COMMUNITY HEALTH CENTER
Practice Location Address:
9710 STATE AVE
MARYSVILLE, WA
98270-2232
Practice Phone: 360-653-1742
Practice Fax: 360-653-2099

Directions to “SEA MAR COMMUNITY HEALTH CENTERS ” Practice Location

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