NPIMap

Organization Active NPI

Seattle Roots Community Health

Doing business as Seattle Roots at Step Clinic

  • Federally Qualified Health Center (FQHC)
  • Seattle, WA
National Provider Identifier
1891343075
Registry record updated Jun 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SEATTLE ROOTS COMMUNITY HEALTH
Doing business as
Seattle Roots at Step Clinic
Seattle Step Clinic
Practice address
1621 S Jackson St
Suite 201
Seattle, WA 98144
Phone
(206) 732-0311
Fax
(206) 299-0855
NPI assigned
Aug 30, 2019
Last updated
Jun 5, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
SEATTLE ROOTS COMMUNITY HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 5, 2025

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

Authorized official

Name
Angie Treptow
Title
Interim Finance Director
Phone
(206) 299-1937

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

1621 S Jackson St
Suite 201
Seattle, WA 98144

Mailing address

2101 E Yesler Way
Suite 210
Seattle, WA 98122-5959
Phone (206) 709-7112

Other identifiers 2

IdentifierTypeStateIssuer
2144223MedicaidWA
UBI601583685OtherWADEPARTMENT OF REVENUE

Other names 2

  • Seattle Roots at Step Clinic Doing business as
  • Seattle Step Clinic Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Seattle

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040308000484 WA Part B Supplier - Clinic/Group Practice 8628966173 Receives reassigned benefits from 66 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Seattle, WA
O20240712000920 WA Part A Provider - Federally Qualified Health Center (FQHC) 8628966173 Practice locations: Seattle, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1891343075. Details of each certification follow.

Federally qualified health center certification: CCN 501061

Legal name
SEATTLE ROOTS COMMUNITY HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 17, 2024
Last certification
Jun 17, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
1621 S Jackson St
Ste 201
Seattle, WA 98144-2277

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory
Tax ID family
Country Doctor Clinic9 organizations share this tax ID, including this one
Part of
Country Doctor Clinic

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Victor Velazquez Individual Corporate Director Jan 1, 2023
Morgan Winters Individual Corporate Director Jan 1, 2023
David Corrado Individual Corporate Director Jan 1, 2023
Christine Asiimwe Individual Corporate Director Jan 1, 2021
Angie J Treptow Individual Corporate Director Jun 22, 2020
W-2 Managing EmployeeDirector of Revenue Cycle & Fo Jun 22, 2020
Grant S Scull Individual Corporate Director Jan 1, 2020
Djenom Benjamin Individual Corporate Director Jan 1, 2022
Kush Doshi Individual Corporate Director Jan 1, 2020
James King Individual Corporate Director Jan 1, 2023
Brandy Taylor Individual Corporate Director Sep 20, 2023
Khang to Individual Corporate Director Jan 1, 2022

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 63

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.

View all 63

NPI Registry JSON

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

{
    "created_epoch": "1567123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749081600000",
    "number": "1891343075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 E YESLER WAY",
            "address_2": "SUITE 210",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981225959",
            "telephone_number": "206-709-7112",
            "fax_number": "206-299-1920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1621 S JACKSON ST",
            "address_2": "SUITE 201",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98144",
            "telephone_number": "206-732-0311",
            "fax_number": "206-299-0855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEATTLE ROOTS COMMUNITY HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SEATTLE ROOTS COMMUNITY HEALTH",
        "enumeration_date": "2019-08-30",
        "last_updated": "2025-06-05",
        "certification_date": "2020-02-11",
        "status": "A",
        "authorized_official_last_name": "TREPTOW",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_title_or_position": "INTERIM FINANCE DIRECTOR",
        "authorized_official_telephone_number": "206-299-1937"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "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": "2144223",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF REVENUE",
            "identifier": "UBI601583685",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Seattle",
            "affiliation": "N",
            "address_1": "2101 E Yesler Way Ste 210",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981225959",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Seattle Roots at Step Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Seattle Step Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.