NPI | 1083179154 |
---|---|
Other Name | SEA MAR ADOLESCENT MEDICAL |
Entity Type | Organization |
Authorized Contact | JOLEE ANN ELIZABETH SANKEY Credentialing Supervisor 206-474-2001 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 208000000X Pediatrics |
Enumeration Date | 2019-02-04 |
Last Update Date | 2019-02-04 |