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SEA-MAR COMMUNITY HEALTH CENTER NPI 1801204078


NPI Information

NPI: 1801204078
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)

CLIA Number: 50D2040083

Address:
14916 WASHINGTON AVE SW
LAKEWOOD, WA
ZIP 98498
Phone: (253) 280-9890
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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 1801204078. 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:

14916 WASHINGTON AVE SW
LAKEWOOD, WA
ZIP 98498-271
Phone: (253) 280-9890
Fax: (253) 582-0273

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

The CLIA number assigned to this NPI record is 50D2040083 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/31/2014 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 License Number License State Primary
1207Q00000XFamily MedicineNo
2207QA0505XFamily MedicineAdult MedicineNo
3207QS0010XFamily MedicineSports MedicineNo
4207R00000XInternal MedicineNo
5207RS0010XInternal MedicineSports MedicineNo
6363A00000XPhysician AssistantNo
7363AM0700XPhysician AssistantMedicalNo
8363L00000XNurse PractitionerNo
9363LA2200XNurse PractitionerAdult HealthNo
10363LF0000XNurse PractitionerFamilyNo
11363LP2300XNurse PractitionerPrimary CareNo
12261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)6005372781WASHINGTONYes

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
12081426MEDICAIDWASHINGTON

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
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