NPIMap

Organization Active NPI

Sea-Mar Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Mount Vernon, WA
National Provider Identifier
1881742724
Registry record updated Mar 12, 2010
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 CENTER
Practice address
110 N Laventure Rd
Suite D
Mount Vernon, WA 98273-3901
Phone
(360) 424-5344
Fax
(360) 424-7850
NPI assigned
Jan 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2010

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

Authorized official

Name
Mary E Bartolo
Title
Deputy Director
Phone
(206) 763-5277

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X
Federally Qualified Health Center (FQHC) 261QF0400X 600537278 WA Primary

Addresses

Primary practice location

110 N Laventure Rd
Suite D
Mount Vernon, WA 98273-3901

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
7034184MedicaidWA

Other names 1

  • Sea Mar Community Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

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…

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

Locations

7424 Bridgeport Way W
Tacoma, WA 98499
Phone (253) 581-2111

Practitioners & affiliated clinicians

Practitioners 12

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

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268352000000",
    "number": "1881742724",
    "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": "110 N LAVENTURE RD",
            "address_2": "SUITE D",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982733901",
            "telephone_number": "360-424-5344",
            "fax_number": "360-424-7850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEA-MAR COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2010-03-12",
        "status": "A",
        "authorized_official_last_name": "BARTOLO",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DEPUTY DIRECTOR",
        "authorized_official_telephone_number": "206-763-5277"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "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": "7034184",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sea Mar Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Vernon, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.