NPIMap

Organization Active NPI

Sea Mar Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Burien, WA
National Provider Identifier
1245387679
Registry record updated Aug 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
600537278 Issued in WA
Legal business name
SEA MAR COMMUNITY HEALTH CENTERS
Practice address
14434 Ambaum Blvd SW Ste 5
Burien, WA 98166-1438
Phone
(206) 812-6140
Fax
(206) 812-2466
NPI assigned
Jan 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mary E Bartolo
Title
Executive Vice President
Phone
(206) 763-5277

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133V00000X
Case Manager/Care CoordinatorGroup: 193200000X MULTI-SPECIALTY GROUP 171M00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Federally Qualified Health Center (FQHC) 261QF0400X 600537278 WA Primary

Addresses

Primary practice location

14434 Ambaum Blvd SW Ste 5
Burien, WA 98166-1438

Mailing address

PO Box 34703
Seattle, WA 98124-1703
Phone (206) 764-3335

Other identifiers 2

IdentifierTypeStateIssuer
1005940MedicaidWA
7134489MedicaidWA

Other names 2

  • Sea-Mar Community Health Center Former legal business name
  • Sea Mar CHC Burien Medical Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040211001210 WA Part B Supplier - Clinic/Group Practice 7315831161 Receives reassigned benefits from 551 practitioners
41 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mount Vernon, WA; Ocean Shores, WA; Olympia, WA; Puyallup, WA; Seattle, WA; Spanaway, WA; Everett, WA; Tacoma, WA…
O20071106000346 WA Part A Provider - Federally Qualified Health Center (FQHC) 7315831161 Practice locations: Burien, WA

Federally qualified health center certification: CCN 501912

Legal name
SEA MAR COMMUNITY HEALTH CENTERS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 23, 2008
Last certification
Apr 23, 2008
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Apr 14, 1977 in WA
Enrollment address
14434 Ambaum Blvd SW
Ste 5
Burien, WA 98166-1438

Other NPIs on the same Medicare enrollment 41

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 41

National Provider Directory

National Provider Directory
Tax ID family
Sea Mar Marysville Medi278 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Ownership & related parties

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Juan Enrique Garza Individual Corporate Director Aug 6, 2024 9%
Daniela Diaz de la Vega Gonzales Individual Corporate DirectorPatient Representative, Homeless Jun 6, 2023 9%
Mary Bartolo Individual Corporate OfficerExecutive Vice President Jun 1, 1978
Agustin Delgado Individual Corporate DirectorVice Chair, Patient Representative Mar 13, 2013 9%
Kristina Kathleen Hoeschen Individual Corporate OfficerChief Compliance Officer- Managing May 1, 2017
W-2 Managing EmployeeChief Compliance Officer- Managing May 1, 2017
Ricardo Gasca Individual Corporate DirectorCommunity Representative Oct 16, 2016 9%
Gregory J Ma Individual Corporate DirectorChair, Patient Representative Sep 1, 1982 9%
Bertha Michelle Danley Individual Corporate DirectorCommunity Representative Nov 1, 2010 9%
Felipe Trinidad-Martinez Individual Corporate DirectorPatient Representative, Migrant May 8, 2008 9%
Erasmo Gamboa Individual Corporate DirectorCommunity Representative Apr 10, 2010 9%
Rogelio Riojas Individual Corporate OfficerCeo Apr 1, 1978
W-2 Managing EmployeeCeo Apr 1, 1978
Silverio Vivanco-Sanchez Individual Corporate DirectorPatient Representative, Migrant May 8, 2008 9%
Jesus R Sanchez Individual Corporate Director Feb 4, 2025 9%

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Sea Mar CHC-Vashon IslandVashon, WA, CCN 941082 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 19, 1978
Sea Mar Community Health CentersSpanaway, WA, CCN 941095 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 19, 1978

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 23

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787788800000",
    "number": "1245387679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34703",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241703",
            "telephone_number": "206-764-3335",
            "fax_number": "206-764-0489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14434 AMBAUM BLVD SW STE 5",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981661438",
            "telephone_number": "206-812-6140",
            "fax_number": "206-812-2466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEA MAR COMMUNITY HEALTH CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A",
        "authorized_official_last_name": "BARTOLO",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "206-763-5277"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "WA",
            "license": "600537278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1005940",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7134489",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sea-Mar Community Health Center",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Sea Mar CHC Burien Medical",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Burien, WA

Sources for this page

Verify at the official NPI Registry.