Organization
SEA - MAR COMMUNITY HEALTH CENTER
Active
Other names
Vancouver BH Tele-Psyche
Organization subpart
No
Provider details
NPI number
Authorized official
JOLEE ANN ELIZABETH SANKEY (CREDENTIALING SUPERVISOR)
(206) 474-2001
Entity
Organization
Contact information
Practice address
5501 NE 109TH CT STE A1, VANCOUVER, WA 98662-6173
(260) 566-4432
(360) 695-0628
Mailing address
PO BOX 34703, SEATTLE, WA 98124-1703
(206) 474-2001
(206) 764-8005
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
04/08/2019
Last updated
04/08/2019
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