NPIMap

Organization Active NPI

Sea Mar Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Olympia, WA
National Provider Identifier
1811320757
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SEA MAR COMMUNITY HEALTH CENTERS
Practice address
3622 Ensign Rd NE
Olympia, WA 98506-5081
Phone
(360) 742-5000
Fax
(360) 742-5019
NPI assigned
Aug 14, 2013
Last updated
Feb 26, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

3622 Ensign Rd NE
Olympia, WA 98506-5081

Mailing address

PO Box 34703
Seattle, WA 98124-1703

Other identifiers 1

IdentifierTypeStateIssuer
2069728MedicaidWA

Other names 2

  • Sea-Mar Community Health Center Former legal business name
  • Sea Mar CHC Thurston County Walk- In Clinic 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…
O20140716002502 WA Part A Provider - Federally Qualified Health Center (FQHC) 7315831161 Practice locations: Olympia, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1811320757. Details of each certification follow.

Federally qualified health center certification: CCN 501969

Legal name
SEA MAR COMMUNITY HEALTH CENTERS
Doing business as
SEA MAR COMMUNITY HEALTH CENTERS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 16, 2014
Last certification
Jul 16, 2014
Ownership / control type
Non-profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Apr 14, 1977 in WA
Enrollment address
3622 Ensign Rd NE
Olympia, WA 98506-5081

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 Clinic279 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 Jun 6, 2023 9%
Mary Bartolo Individual Corporate OfficerExecutive Vice President Apr 17, 1978
W-2 Managing EmployeeExecutive Vice President Apr 17, 1978
Agustin Delgado Individual Corporate DirectorVice Chair 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 DirectorVice Chair Oct 16, 2016 9%
Gregory J Ma Individual Corporate DirectorChair Sep 1, 1982 9%
Bertha Michelle Danley Individual Corporate DirectorQuality Improvement Committee Chair Nov 1, 2010 9%
Felipe Trinidad-Martinez Individual Corporate DirectorMigrant Representative May 8, 2008 9%
Erasmo Gamboa Individual Corporate DirectorTreasurer Apr 10, 2010 9%
Rogelio Riojas Individual Corporate OfficerCeo Apr 1, 1978
W-2 Managing EmployeeCeo Apr 1, 1978
Silverio Vivanco-Sanchez Individual Corporate DirectorMigrant Representative 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 1

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": "1376438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740528000000",
    "number": "1811320757",
    "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": "3622 ENSIGN RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065081",
            "telephone_number": "360-742-5000",
            "fax_number": "360-742-5019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEA MAR COMMUNITY HEALTH CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-14",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A",
        "authorized_official_last_name": "BARTOLO",
        "authorized_official_first_name": "MARY",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2069728",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sea-Mar Community Health Center",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Sea Mar CHC Thurston County Walk- In Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.