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  5. SEATTLE INDIAN HEALTH BOARD

SEATTLE INDIAN HEALTH BOARD

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Company Details

Legal Name: SEATTLE INDIAN HEALTH BOARD
Jurisdiction: WASHINGTON
Entity Type: WA NONPROFIT CORPORATION
Category: DOMESTIC ENTITY
Status: Administratively Dissolved
Formation/ Registration Date: March 26th 1970
Date of Dissolution: August 3rd 2025
Expiration date: 31 Mar 2025
UBI Number: 600 440 936
FEIN Number: 91-0869056
Purpose: SEATTLE INDIAN HEALTH BOARD OPERATES A HEALTH PROGRAM CONSISTING OF A MEDICAL AND DENTAL CLINIC WITH A LABORATORY, PHARMACY, AND NUTRITION SERVICES; AN INPATIENT CHEMICAL DEPENDENCY TREATMENT CENTER (THUNDERBIRD); MENTAL HEALTH AND SOCIAL SERVICES OUTREACH PROGRAMS; AND AN EDUCATION PROGRAM TO IMPROVE THE PHYSICAL, MENTAL, SPIRITUAL, AND SOCIAL HEALTH OF AMERICAN INDIANS AND ALASKAN NATIVES RESIDING IN THE GREATER SEATTLE AREA THROUGH THE PROVISION OF CULTURALLY SENSITIVE SERVICES.
ZIP code: 98133
City: Seattle
County: KING
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 611 N 112TH ST, SEATTLE, WA, 98133-2007, UNITED STATES
Supporting healthcare providers fighting with COVID-19: $1,298,068

Contact Details

E-Mail: ZECHARIASM@SIHB.ORG
BRIANJ@SIHB.ORG
Phone Number: +1 425-345-9757
+1 206-324-9360

Nature of Business

Charitable, NON-PROFIT COMMUNITY HEALTH CENTER

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Registered Agent Information

Name Role
SEATTLE INDIAN HEALTH BOARD Registered Agent

Key Officers & Management

Name Role Address
ESTHER LUCERO CEO 611 12TH AVE S, SEATTLE, WA, 98144-2007, UNITED STATES
RAY OEN CFO 611 12TH AVE S, SEATTLE, WA, 98144-2007, UNITED STATES
ABIGAIL ECHO-HAWK EXECUTIVE VICE PRESIDENT 611 12TH AVE S, SEATTLE, WA, 98144-2007, UNITED STATES
TOM WARREN Governing Person -

Unique Entity ID

Unique Entity ID:
T4PQLK8JNHL1
CAGE Code:
3T5A6
UEI Expiration Date:
2025-12-26

Business Information

URL:
http://www.sihb.org
Activation Date:
2024-12-30
Initial Registration Date:
2004-04-12

Commercial and government entity program

CAGE number:
3T5A6
Status:
Active
Type:
Non-Manufacturer
CAGE Update Date:
2024-12-30
CAGE Expiration:
2029-12-30
SAM Expiration:
2025-12-26
CAGE Link:
View company profile on CAGE website

Contact Information

POC:
ESTHER LUCERO
Corporate URL:
http://www.sihb.org

National Provider Identifier

NPI Number:
1336715762
Certification Date:
2021-05-17
Link:
View on NPI website

Authorized Person:

Name:
ANGELA LAFONTAINE
Role:
REVENUE CYCLE MANAGER
Phone:
2063244036

Taxonomy:

Selected Taxonomy:
261QD0000X - Dental Clinic/Center
Is Primary:
No
Selected Taxonomy:
261QF0400X - Federally Qualified Health Center (FQHC)
Is Primary:
Yes

Contacts:

Phone:
+1 206-324-9360

Form 5500 Series

Employer Identification Number (EIN):
910869056
Plan Year:
2021
Number Of Participants:
169
Sponsor's telephone number:
2063249360
File:
View File
Plan Year:
2020
Number Of Participants:
168
Sponsor's telephone number:
2063249360
File:
View File
Plan Year:
2019
Number Of Participants:
190
Sponsor's telephone number:
2063249360
File:
View File
Plan Year:
2018
Number Of Participants:
163
Sponsor's telephone number:
2063249360
File:
View File
Plan Year:
2017
Number Of Participants:
176
Sponsor's telephone number:
2063249360
File:
View File

USAspending Awards / Contracts

Procurement Instrument Identifier:
75H71320C00002
Link:
View Award on USAspending website
Award Or Idv Flag:
AWARD
Award Type:
DEFINITIVE CONTRACT
Action Obligation:
$0
Base And Exercised Options Value:
$0
Base And All Options Value:
$0
Awarding Agency Name:
Department of Health and Human Services
Performance Start Date:
2020-04-19
Description:
EXERCISE OPTION YEAR ONE (1) FOR THE PERIOD OF OCTOBER 1, 2020 THROUGH SEPTEMBER 30, 2021.
Naics Code:
621999: ALL OTHER MISCELLANEOUS AMBULATORY HEALTH CARE SERVICES
Product Or Service Code:
Q999: MEDICAL- OTHER
Procurement Instrument Identifier:
HHSD2002009M31386P
Link:
View Award on USAspending website
Award Or Idv Flag:
AWARD
Award Type:
PO
Action Obligation:
$50,000
Base And Exercised Options Value:
$50,000
Base And All Options Value:
$50,000
Awarding Agency Name:
Department of Health and Human Services
Performance Start Date:
2009-08-17
Description:
TESTING OF SV DEFINITIONS
Naics Code:
621498: ALL OTHER OUTPATIENT CARE CENTERS
Product Or Service Code:
9999: MISCELLANEOUS ITEMS
Procurement Instrument Identifier:
HHSI24820060001C
Link:
View Award on USAspending website
Award Or Idv Flag:
IDV
Action Obligation:
$109,656
Base And Exercised Options Value:
$0
Base And All Options Value:
$109,656
Awarding Agency Name:
Department of Health and Human Services
Performance Start Date:
2008-09-30
Description:
COMPREHENSIVE HEALTH CARE DELIVERY SYSTEM
Naics Code:
621999: ALL OTHER MISCELLANEOUS AMBULATORY HEALTH CARE SERVICES
Product Or Service Code:
Q201: GENERAL HEALTH CARE SERVICES

OSHA's Inspections within Industry

Inspection Summary

Date:
2010-08-24
Type:
Complaint
Address:
611 12TH AVE S SUITE 200, SEATTLE, WA, 98144
Safety Health:
Safety
Scope:
Partial
Inspection Link:
View Inspection data on OSHA website

Tax Exempt

Employer Identification Number (EIN):
91-0869056
Ruling Date:
1971-02
Deductibility:
Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Copies of Returns

Return Type:
990
Tax Period:
202209
Link:
Download 990
Return Type:
990
Tax Period:
202109
Link:
Download 990
Return Type:
990
Tax Period:
201909
Link:
Download 990

Motor Carrier Census

Carrier Operation:
Intrastate Non-Hazmat
Phone:
(206) 324-9360
Fax:
(206) 324-8910
Email:
TEDE@SIHB.ORG
Add Date:
2021-06-03
Operation Classification:
Private(Property)
power Units:
3
Drivers:
2
Inspections:
0
FMCSA Link:
View on FMCSA website

Labor Condition Applications

Case Number:
I-200-14252-756984
Program:
H-1B
Job Title:
DENTIST
SOC (ONET/OES) code:
29-1021
SOC (ONET/OES) occupation title:
Dentists, General
Begin Date:
2014-09-15
End Date:
2017-09-15

Employment and Wage Information

Address:
SEATTLE, WA
Wage Rate Paid to Nonimmigrant Workers:
$49.59
Per:
Hour
Prevailing Wage Rate:
$46.32

Charity/Fundraiser/Trust

Registration Number:
1104187
Type:
CHARITABLE ORGANIZATION
Status:
Active
Renewal Date:
2026-08-31

Financial History

Fiscal Begin Date:
2023-10-01
Fiscal End Date:
2024-09-30
Begin Assets:
$48,824,415.00
Revenue:
$47,442,233.00
Program Services:
$24,499,514.00
Expenses:
$38,206,374.00
End Assets:
$58,161,807.00
% To Program Services:
64%
Fiscal Begin Date:
2022-10-01
Fiscal End Date:
2023-09-30
Begin Assets:
$35,510,203.00
Revenue:
$50,294,695.00
Program Services:
$19,946,780.00
Expenses:
$36,213,896.00
End Assets:
$48,824,415.00
% To Program Services:
55%
Fiscal Begin Date:
2021-10-01
Fiscal End Date:
2022-09-30
Begin Assets:
$30,642,296.00
Revenue:
$29,958,460.00
Program Services:
$17,869,053.00
Expenses:
$30,089,600.00
End Assets:
$35,510,203.00
% To Program Services:
59%
Fiscal Begin Date:
2020-10-01
Fiscal End Date:
2021-09-30
Begin Assets:
$24,258,366.00
Revenue:
$38,824,679.00
Program Services:
$16,484,987.00
Expenses:
$29,745,956.00
End Assets:
$30,642,296.00
% To Program Services:
55%
Fiscal Begin Date:
2019-10-01
Fiscal End Date:
2020-09-30
Begin Assets:
$15,882,155.00
Revenue:
$26,335,591.00
Program Services:
$12,916,901.00
Expenses:
$22,707,329.00
End Assets:
$24,258,366.00
% To Program Services:
57%
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