SEA-MAR COMMUNITY HEALTH CENTER NPI 1689721011

NPI Information

NPI: 1689721011
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:
6884 HANNEGAN RD
EVERSON, WA
ZIP 98247
Phone: (360) 354-0766
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SEA-MAR COMMUNITY HEALTH CENTER is a federally qualified health center (fqhc) clinic center in Everson, WA. SEA-MAR COMMUNITY HEALTH CENTER NPI is 1689721011. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Sea-mar Community Health Center.

The provider's business location address is:

6884 HANNEGAN RD
EVERSON, WA
ZIP 98247-637
Phone: (360) 354-0766
Fax: (360) 354-6939

The provider's authorized official is Mary Bartolo .
The authorized official title is Executive Vice President and has the following contact phone number (206) 788-3224.

The CLIA number assigned to this NPI record is 50D1099321 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/5/2007 and was last updated on 6/15/2023.

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	License Number	License State	Primary
1	207Q00000X	Family Medicine				No
2	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)	6005372781	WASHINGTON	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	1016414	MEDICAID	WASHINGTON
2	7065667	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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