Organization
SEA MAR COMMUNITY HEALTH CENTERS
Active
Other names
Sea Mar CHC Tacoma Medical - 11th Street, Sea-Mar Community Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MARY BARTOLO (EXECUTIVE VICE PRESIDENT)
(206) 764-3335
Entity
Organization
Contact information
Practice address
1307 S 11TH ST, TACOMA, WA 98405-3644
(253) 682-2180
(253) 682-2181
Mailing address
PO BOX 34703, SEATTLE, WA 98124-1703
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207QA0505X
Adult Medicine Physician
—
—
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RS0010X
Sports Medicine (Internal Medicine) Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
208D00000X
General Practice Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
363A00000X
Physician Assistant
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
363LW0102X
Women's Health Nurse Practitioner
—
—
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2076698
—
WA
Enumeration date
12/06/2016
Last updated
02/26/2025
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