SEA-MAR COMMUNITY HEALTH CENTER NPI 1144643479

NPI Information

NPI: 1144643479
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:
202 CULLENS ST NW
YELM, WA
ZIP 98597
Phone: (360) 400-4800
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SEA-MAR COMMUNITY HEALTH CENTER is a federally qualified health center (fqhc) clinic center in Yelm, WA. SEA-MAR COMMUNITY HEALTH CENTER NPI is 1144643479. 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:

202 CULLENS ST NW
YELM, WA
ZIP 98597-417
Phone: (360) 400-4800
Fax: (360) 400-4821

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 1/22/2014 and was last updated on 9/13/2023.

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	207Q00000X	Family Medicine		No
2	207QA0000X	Family Medicine	Adolescent Medicine	No
3	207QA0401X	Family Medicine	Addiction Medicine	No
4	207QA0505X	Family Medicine	Adult Medicine	No
5	207QG0300X	Family Medicine	Geriatric Medicine	No
6	207QS0010X	Family Medicine	Sports Medicine	No
7	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	2037166	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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