Organization Name: | SEA-MAR COMMUNITY HEALTH CENTER |
NPI Number: | 1023247541 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARY E BARTOLO (DEPUTY DIRECTOR) |
Mailing Address: | 1415 E Kincaid St Mount Vernon |
State: | WA US |
Postal Code: | 982744126 |
Phone Number: | 3605585550 |
Fax Number: | 3605525589 |
NPI Enumeration Date: | 07/06/2009 |
NPI Last Update Date: | 10/25/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QF0400X |
License Number: | 6005372781 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
Taxonomy Definition: |