Provider Demographics
NPI:1790136943
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:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROGELIO
Authorized Official - Middle Name:
Authorized Official - Last Name:RIOJAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-763-5277
Mailing Address - Street 1:8801 14TH AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98108-4809
Mailing Address - Country:US
Mailing Address - Phone:206-474-2001
Mailing Address - Fax:206-764-8005
Practice Address - Street 1:597 POINT BROWN AVE NE
Practice Address - Street 2:
Practice Address - City:OCEAN SHORES
Practice Address - State:WA
Practice Address - Zip Code:98569
Practice Address - Country:US
Practice Address - Phone:360-289-2427
Practice Address - Fax:360-289-9982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-29
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental