| Sea Mar Chc - Community Services Northwest - Fourth Plain Sud | |
|
1601 E Fourth Plain Blvd Bldg 17 Vancouver WA 98661-3717 | |
| (360) 397-8484 | |
| (360) 397-8494 |
| Full Name | Sea Mar Chc - Community Services Northwest - Fourth Plain Sud |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 1601 E Fourth Plain Blvd Bldg 17, Vancouver, 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 - Community Services Northwest - Fourth Plain Sud Po Box 34703 Seattle WA 98124-1703 Ph: (206) 474-2001 | Sea Mar Chc - Community Services Northwest - Fourth Plain Sud 1601 E Fourth Plain Blvd Bldg 17 Vancouver WA 98661-3717 Ph: (360) 397-8484 |
| NPI Number | 1669038543 |
|---|---|
| Provider Enumeration Date | 05/15/2019 |
| Last Update Date | 03/12/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669038543 | NPI | - | NPPES |
| 2135934 | Medicaid | WA |
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