NPIMap

Organization Active NPI

Seattle Roots Community Health

  • Federally Qualified Health Center (FQHC)
  • Seattle, WA
National Provider Identifier
1972623189
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
Practice address
2101 E Yesler Way Ste 210
Seattle, WA 98122-5959
Phone
(206) 299-1984
Fax
(206) 299-1920
NPI assigned
Mar 30, 2007
Last updated
Jun 5, 2025By the provider in NPPES
Organization subpart
No

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NU
Community Health Clinic/Center 261QC1500X 477569294 WA
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

2101 E Yesler Way Ste 210
Seattle, WA 98122-5959

Mailing address

2101 E Yesler Way
Suite 210
Seattle, WA 98122-5959
Phone (206) 299-1942

Other identifiers 1

IdentifierTypeStateIssuer
1023560MedicaidWA

Other names 1

  • Country Doctor Community Health Center Former legal business name

Medicare participation

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

Enrollment records 1

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
Practice locations: Seattle, WA

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

Locations

301 21st Ave E
Seattle, WA 98112
Phone (206) 709-7190

Ownership & related parties

Subparts reporting this organization as parent 5

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 81

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 81

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749081600000",
    "number": "1972623189",
    "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": "206-299-1942",
            "fax_number": "206-299-1920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 E YESLER WAY STE 210",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981225959",
            "telephone_number": "206-299-1984",
            "fax_number": "206-299-1920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEATTLE ROOTS COMMUNITY HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2025-06-05",
        "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": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "WA",
            "license": "477569294",
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023560",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Country Doctor Community Health Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2025; 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.