| Sea Mar Chc Mt Vernon Behavioral Health - Old Highway | |
|
2203 Old Hwy 99 S Mount Vernon WA 98273-9009 | |
| (206) 474-2001 | |
| (206) 764-8005 |
| Full Name | Sea Mar Chc Mt Vernon Behavioral Health - Old Highway |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 2203 Old Hwy 99 S, Mount Vernon, 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 Mt Vernon Behavioral Health - Old Highway Po Box 34703 Seattle WA 98124-1703 Ph: (206) 474-2001 | Sea Mar Chc Mt Vernon Behavioral Health - Old Highway 2203 Old Hwy 99 S Mount Vernon WA 98273-9009 Ph: (206) 474-2001 |
| NPI Number | 1407325368 |
|---|---|
| Provider Enumeration Date | 11/20/2018 |
| Last Update Date | 03/12/2024 |
| Certification Date | 03/12/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407325368 | NPI | - | NPPES |
| 2135941 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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