Organization
SEATTLE ROOTS COMMUNITY HEALTH
Active
Parent organization
SEATTLE ROOTS COMMUNITY HEALTH
Other names
Country Doctor Community Clinic, Seattle Roots at Country Doctor
Organization subpart
Yes
Provider details
NPI number
Legal business name
SEATTLE ROOTS COMMUNITY HEALTH
Authorized official
MS. ANGIE TREPTOW (INTERIM FINANCE DIRECTOR)
(206) 299-1937
Entity
Organization
Contact information
Practice address
500 19TH AVE E, SEATTLE, WA 98112
(206) 299-1600
(206) 299-1608
Mailing address
2101 E YESLER WAY, SUITE 210, SEATTLE, WA 98122-5959
(206) 709-7112
(209) 299-1920
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
261QC1500X
Community Health Clinic/Center
601583685
WA
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1014895
—
WA
01
—
16943
L&I
WA
01
—
600508852
UBI
WA
05
—
6013965
—
WA
05
—
6014948
—
WA
05
—
7034044
—
WA
05
—
7034598
—
WA
05
—
7590243
—
WA
05
—
7900632
—
WA
05
—
8016081
—
WA
05
—
8016438
—
WA
05
—
8064602
—
WA
Enumeration date
12/28/2005
Last updated
06/05/2025
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