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
1	104100000X	Social Worker
2	133V00000X	Registered Dietitian
3	171M00000X	Case Manager/Care Coordinator
4	261QF0400X	Federally Qualified Health Center (FQHC)

Other Identifiers

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

General Provider Information

NPI Number	:	1619534161
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	:	905 24TH WAY SW STE B3
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98502-6033
Country	:	US
Telephone Number	:	360-742-5010
Fax Number	:	360-742-5015

Authorized Official
Title or Position	:	EXECUTIVE VICE PRESIDENT
Name	:	MARY BARTOLO
Credential	:
Telephone Number	:	206-763-5277

Provider Enumeration Date	:	05/21/2019
Last Update Date	:	01/31/2025

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