Organization
SEA MAR COMMUNITY HEALTH CENTERS
Active
Other names
Sea Mar CHC Lynnwood Dental, Sea-Mar Community Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MARY BARTOLO (EXECUTIVE VICE PRESIDENT)
(206) 788-3263
Entity
Organization
Contact information
Practice address
4111 ALDERWOOD MALL BLVD, LYNNWOOD, WA 98036-6765
(425) 977-2580
(425) 977-2565
Mailing address
PO BOX 34703, SEATTLE, WA 98124-1703
(206) 764-3335
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
124Q00000X
Dental Hygienist
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2223343
—
WA
Enumeration date
02/14/2017
Last updated
01/31/2025
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