Organization
SEA MAR COMMUNITY HEALTH CENTERS
Active
Other names
Sea-Mar Community Health Center, Sea Mar CHC Tacoma Dental (Tacoma Cushman)
Organization subpart
No
Provider details
NPI number
Authorized official
MARY BARTOLO (DEPUTY DIRECTOR)
(206) 788-3224
Entity
Organization
Contact information
Practice address
1112 S CUSHMAN AVE, TACOMA, WA 98405-3631
(253) 280-9770
(253) 246-6822
Mailing address
PO BOX 34703, SEATTLE, WA 98124-1703
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
6005372781
WA
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003524
—
WA
Enumeration date
01/08/2007
Last updated
01/31/2025
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