| Sea Mar Chc Tacoma - 19th Street Child And Family Services | |
|
2121 S 19th St Tacoma WA 98405-2922 | |
| (253) 396-1634 | |
| (253) 396-1663 |
| Full Name | Sea Mar Chc Tacoma - 19th Street Child And Family Services |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 2121 S 19th St, Tacoma, Washington |
| Authorized Official Name and Position | Rogelio Riojas (CEO) |
| Authorized Official Contact | 2067635277 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sea Mar Chc Tacoma - 19th Street Child And Family Services Po Box 34703 Seattle WA 98124-1703 Ph: (206) 764-3335 | Sea Mar Chc Tacoma - 19th Street Child And Family Services 2121 S 19th St Tacoma WA 98405-2922 Ph: (253) 396-1634 |
| NPI Number | 1710035100 |
|---|---|
| Provider Enumeration Date | 01/08/2007 |
| Last Update Date | 03/12/2024 |
| Certification Date | 03/12/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710035100 | NPI | - | NPPES |
| 1017028 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 6005372781 (Washington) | Primary |
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