NPIMap

Organization Active NPI

Sea Mar Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Mount Vernon, WA
National Provider Identifier
1528115870
Registry record updated Aug 31, 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
1400 N Laventure Rd
Mount Vernon, WA 98273-2766
Phone
(360) 542-8900
Fax
(360) 542-8796
NPI assigned
Jan 5, 2007
Last updated
Aug 31, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 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 14

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 600537278 WA Primary
Physician Assistant 363A00000X NU
Nurse Practitioner 363L00000X NU
Family Nurse Practitioner 363LF0000X NU
Pediatric Nurse Practitioner 363LP0200X NU
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU
Advanced Practice Midwife 367A00000X NU
Registered Dietitian 133V00000X NU
Family Medicine Physician 207Q00000X NU
Addiction Medicine (Family Medicine) Physician 207QA0401X NU
Obstetrics & Gynecology Physician 207V00000X NU
Reproductive Endocrinology Physician 207VE0102X NU
Maternal & Fetal Medicine Physician 207VM0101X NU
Case Manager/Care Coordinator 171M00000X NU

Addresses

Primary practice location

1400 N Laventure Rd
Mount Vernon, WA 98273-2766

Mailing address

PO Box 34703
Seattle, WA 98124-1703

Other identifiers 2

IdentifierTypeStateIssuer
7034184MedicaidWA
1012571MedicaidWA

Other names 2

  • Sea-Mar Community Health Center Former legal business name
  • Sea Mar CHC Mt. Vernon 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…
O20040513000912 WA Part A Provider - Federally Qualified Health Center (FQHC) 7315831161 Practice locations: Mount Vernon, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1528115870. Details of each certification follow.

Federally qualified health center certification: CCN 501824

Legal name
SEA MAR COMMUNITY HEALTH CENTERS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 1, 1991
Last certification
Oct 1, 1991
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 19, 1978 in WA
Enrollment address
1400 N Laventure Rd
Mount Vernon, WA 98273-2766
Related CCNs
507052

Facilities connected through Provider of Services related, parent or unit certification numbers.

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 Medi279 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 Director Jun 6, 2023 9%
Mary Bartolo Individual Corporate OfficerExecutive Vice President Jun 10, 2004
W-2 Managing EmployeeExecutive Vice President Jun 10, 2004
Agustin Delgado Individual Corporate Director Mar 13, 2013 9%
Kristina Kathleen Hoeschen Individual Corporate OfficerChief Compliance Officer May 1, 2017
W-2 Managing EmployeeChief Compliance Officer May 1, 2017
Ricardo Gasca Individual Corporate Director Oct 16, 2016 9%
Gregory J Ma Individual Corporate Director Jun 10, 2004 9%
Bertha Michelle Danley Individual Corporate Director Jun 10, 2004 9%
Felipe Trinidad-Martinez Individual Corporate Director May 8, 2008 9%
Erasmo Gamboa Individual Corporate Director Apr 10, 2010 9%
Rogelio Riojas Individual Corporate OfficerPresident & Ceo Apr 20, 2004
Silverio Vivanco-Sanchez Individual Corporate Director 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 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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": "1788134400000",
    "number": "1528115870",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N LAVENTURE RD",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982732766",
            "telephone_number": "360-542-8900",
            "fax_number": "360-542-8796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEA MAR COMMUNITY HEALTH CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "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": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "WA",
            "license": "600537278",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7034184",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1012571",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sea-Mar Community Health Center",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Sea Mar CHC Mt. Vernon Medical",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mount Vernon, WA

Sources for this page

Verify at the official NPI Registry.