SEA-MAR COMMUNITY HEALTH CENTER NPI 1699394767

NPI Information

NPI: 1699394767
Provider Name: SEA-MAR COMMUNITY HEALTH CENTER

Former Legal Business Name: SEA - MAR COMMUNITY HEALTH CENTER

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
7424 BRIDGEPORT WAY W
LAKEWOOD, WA
ZIP 98499
Phone: (253) 240-2110
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SEA-MAR COMMUNITY HEALTH CENTER is a federally qualified health center (fqhc) clinic center in Lakewood, WA. SEA-MAR COMMUNITY HEALTH CENTER NPI is 1699394767. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Sea - Mar Community Health Center.

The provider's business location address is:

7424 BRIDGEPORT WAY W
LAKEWOOD, WA
ZIP 98499-120
Phone: (253) 240-2110
Fax: (253) 240-2111

The provider's authorized official is Mary Bartolo .
The authorized official title is Executive Vice President and has the following contact phone number (206) 763-5277.

The enumeration date for this NPI number is 4/9/2020 and was last updated on 9/11/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	152W00000X	Optometrist		No
2	207Q00000X	Family Medicine		No
3	207QS0010X	Family Medicine	Sports Medicine	No
4	207R00000X	Internal Medicine		No
5	207RC0000X	Internal Medicine	Cardiovascular Disease	No
6	207RE0101X	Internal Medicine	Endocrinology, Diabetes & Metabolism	No
7	207RR0500X	Internal Medicine	Rheumatology	No
8	208000000X	Pediatrics		No
9	2080P0008X	Pediatrics	Neurodevelopmental Disabilities	No
10	208100000X	Physical Medicine & Rehabilitation		No
11	225100000X	Physical Therapist		No
12	225X00000X	Occupational Therapist		No
13	363A00000X	Physician Assistant		No
14	363L00000X	Nurse Practitioner		No
15	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	2156551	MEDICAID	WASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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