MEDICARE: SEA-MAR COMMUNITY HEALTH CENTER

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
1	132700000X	Dietary Manager
2	261QF0400X	Federally Qualified Health Center (FQHC)	6005372781	WA

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	:	1649316605
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SEA-MAR COMMUNITY HEALTH CENTER

Provider Business Mailing Address
First Line	:	PO BOX 34703
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98124-1703
Country	:	US
Telephone Number	:	206-764-3335
Fax Number	:	206-764-0489

Provider Business Practice Location Address
First Line	:	8915 14TH AVE S
Second Line	:	1ST FLOOR
City	:	SEATTLE
State	:	WA
Zip	:	98108-4813
Country	:	US
Telephone Number	:	206-762-0876
Fax Number	:	206-763-1856

Authorized Official
Title or Position	:	DEPUTY DIRECTOR
Name	:	MARY BARTOLO
Credential	:
Telephone Number	:	206-788-3224

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	12/30/2019

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Directions to “SEA-MAR COMMUNITY HEALTH CENTER ” Practice Location

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