NPIMap

Organization Active NPI

Sea Mar Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Seattle, WA
National Provider Identifier
1962588426
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
8720 14TH Ave S
Seattle, WA 98108-4807
Phone
(206) 762-3730
Fax
(206) 764-0523
NPI assigned
Oct 27, 2006
Last updated
Aug 27, 2026By the provider in NPPES
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
Federally Qualified Health Center (FQHC) 261QF0400X 600537278 WA Primary
Registered Dietitian 133V00000X
Family Medicine Physician 207Q00000X
Case Manager/Care Coordinator 171M00000X

Addresses

Primary practice location

8720 14TH Ave S
Seattle, WA 98108-4807

Mailing address

PO Box 34703
Seattle, WA 98124-1703

Other identifiers 2

IdentifierTypeStateIssuer
1023386MedicaidWA
7034218MedicaidWA

Other names 2

  • Sea - Mar Community Health Center Former legal business name
  • Sea Mar CHC Seattle 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…
O20040513000923 WA Part A Provider - Federally Qualified Health Center (FQHC) 7315831161 Practice locations: Seattle, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1962588426. Details of each certification follow.

Federally qualified health center certification: CCN 501823

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
Oct 1, 1991
Last certification
Oct 1, 1991
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Dec 11, 2006 in WA
Enrollment address
8720 14TH Ave S
Seattle, WA 98108-4807
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

Locations

10030 SW 210th St
Vashon, WA 98070
Phone (206) 463-3671

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 DirectorBoard Member 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 DirectorBoard Member 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 DirectorBoard Member Oct 16, 2016 9%
Gregory J Ma Individual Corporate DirectorBoard Member Sep 1, 1982 9%
Bertha Michelle Danley Individual Corporate DirectorBoard Member Nov 1, 2010 9%
Felipe Trinidad-Martinez Individual Corporate DirectorBoard Member May 1, 2008 9%
Erasmo Gamboa Individual Corporate DirectorBoard Member Apr 10, 2010 9%
Rogelio Riojas Individual Corporate OfficerCeo Jun 19, 1978
W-2 Managing EmployeeCeo Jun 19, 1978
Silverio Vivanco-Sanchez Individual Corporate DirectorBoard Member May 1, 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 30

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 30

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787788800000",
    "number": "1962588426",
    "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": "8720 14TH AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981084807",
            "telephone_number": "206-762-3730",
            "fax_number": "206-764-0523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEA MAR COMMUNITY HEALTH CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "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": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "WA",
            "license": "600537278",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023386",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7034218",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sea - Mar Community Health Center",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Sea Mar CHC Seattle Medical",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.