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Organization

SEA MAR COMMUNITY HEALTH CENTERS

Active
Other names
Sea Mar CHC Tillicum Medical, Sea-Mar Community Health Center
Organization subpart
No

Provider details

NPI number
Authorized official
MARY BARTOLO (EXECUTIVE DIRECTOR)
(206) 763-5277
Entity
Organization

Contact information

Practice address
14916 WASHINGTON AVE SW, LAKEWOOD, WA 98498-2271
(253) 280-9890
(253) 582-0273
Mailing address
PO BOX 34703, SEATTLE, WA 98124-1703

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
207QA0505X
Adult Medicine Physician
207QS0010X
Sports Medicine (Family Medicine) Physician
207R00000X
Internal Medicine Physician
207RS0010X
Sports Medicine (Internal Medicine) Physician
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
6005372781
WA
363A00000X
Physician Assistant
363AM0700X
Medical Physician Assistant
363L00000X
Nurse Practitioner
363LA2200X
Adult Health Nurse Practitioner
363LF0000X
Family Nurse Practitioner
363LP2300X
Primary Care Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2081426
WA
Enumeration date
07/31/2014
Last updated
02/26/2025
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