SEA-MAR COMMUNITY HEALTH CENTER NPI 1922624642

NPI Information

NPI: 1922624642
Provider Name: SEA-MAR COMMUNITY HEALTH CENTER

Former Legal Business Name: SEA-MAR COMMUNITY HEALTH CENTER

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
225 176TH ST S
SPANAWAY, WA
ZIP 98387
Phone: (253) 240-2130
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SEA-MAR COMMUNITY HEALTH CENTER is a federally qualified health center (fqhc) clinic center in Spanaway, WA. SEA-MAR COMMUNITY HEALTH CENTER NPI is 1922624642. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Sea-mar Community Health Center.

The provider's business location address is:

225 176TH ST S
SPANAWAY, WA
ZIP 98387-201
Phone: (253) 240-2130
Fax: (253) 240-2133

The provider's authorized official is Mary Bartolo .
The authorized official title is Executive Vice President and has the following contact phone number (206) 763-5277.

The CLIA number assigned to this NPI record is 50D2213225 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/18/2020 and was last updated on 8/24/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	133V00000X	Dietitian, Registered		No
2	133VN1004X	Dietitian, Registered	Nutrition, Pediatric	No
3	133VN1005X	Dietitian, Registered	Nutrition, Renal	No
4	133VN1006X	Dietitian, Registered	Nutrition, Metabolic	No
5	163W00000X	Registered Nurse		No
6	133N00000X	Nutritionist		No
7	174H00000X	Health Educator		No
8	208100000X	Physical Medicine & Rehabilitation		No
9	2081P0004X	Physical Medicine & Rehabilitation	Spinal Cord Injury Medicine	No
10	2081S0010X	Physical Medicine & Rehabilitation	Sports Medicine	No
11	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	No
12	225X00000X	Occupational Therapist		No
13	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	2164523	MEDICAID	WASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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