SEA-MAR COMMUNITY HEALTH CENTER NPI 1104974419

NPI Information

NPI: 1104974419
Provider Name: SEA-MAR COMMUNITY HEALTH CENTER

Doing Business As: SEA MAR COMMUNITY HEALTH CENTER

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

Specialization: Federally Qualified Health Center (FQHC)

Address:
1112 S CUSHMAN AVE
TACOMA, WA
ZIP 98405
Phone: (253) 593-2144
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SEA-MAR COMMUNITY HEALTH CENTER is a federally qualified health center (fqhc) clinic center in Tacoma, WA. SEA-MAR COMMUNITY HEALTH CENTER NPI is 1104974419. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Sea Mar Community Health Center.

The provider's business location address is:

1112 S CUSHMAN AVE
TACOMA, WA
ZIP 98405-631
Phone: (253) 593-2144
Fax: (253) 246-6725

The provider's authorized official is Mary E 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 1/5/2007 and was last updated on 8/24/2023.

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
1	208000000X	Pediatrics				No
2	2080N0001X	Pediatrics	Neonatal-Perinatal Medicine			No
3	2080P0203X	Pediatrics	Pediatric Critical Care Medicine			No
4	208D00000X	General Practice				No
5	207RI0200X	Internal Medicine	Infectious Disease			No
6	207RS0012X	Internal Medicine	Sleep Medicine			No
7	207Q00000X	Family Medicine				No
8	207QA0401X	Family Medicine	Addiction Medicine			No
9	207QS0010X	Family Medicine	Sports Medicine			No
10	207R00000X	Internal Medicine				No
11	363LF0000X	Nurse Practitioner	Family			No
12	363A00000X	Physician Assistant				No
13	363L00000X	Nurse Practitioner				No
14	363LP2300X	Nurse Practitioner	Primary Care			No
15	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)	600537278	WASHINGTON	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	1002613	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: 4/28/2024

NPI Synchronization or Removal

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