Provider Demographics
NPI:1518364413
Name:SEA MAR COMMUNITY HEALTH CENTERS
Entity Type:Organization
Organization Name:SEA MAR COMMUNITY HEALTH CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAOLA
Authorized Official - Middle Name:MERCEDES
Authorized Official - Last Name:SALDANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-805-3122
Mailing Address - Street 1:14090 FRYELANDS BLVD SE
Mailing Address - Street 2:SUITE 347
Mailing Address - City:MONROE
Mailing Address - State:WA
Mailing Address - Zip Code:98272-2693
Mailing Address - Country:US
Mailing Address - Phone:360-805-3122
Mailing Address - Fax:360-805-9180
Practice Address - Street 1:14090 FRYELANDS BLVD SE
Practice Address - Street 2:SUITE 347
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272-2693
Practice Address - Country:US
Practice Address - Phone:360-805-3122
Practice Address - Fax:360-805-9180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-21
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACO60521671101YA0400X
WACG60399925251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase Management
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty