1356591077 NPI number — PUBLIC HOSPITAL DISTRICT NO 2 SKAGIT COUNTY WASHINGTON

Table of content: (NPI 1356591077)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356591077 NPI number — PUBLIC HOSPITAL DISTRICT NO 2 SKAGIT COUNTY WASHINGTON

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PUBLIC HOSPITAL DISTRICT NO 2 SKAGIT COUNTY WASHINGTON
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
FIDALGO MEDICAL ASSOCIATES AT ISLAND HOSPITAL
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1356591077
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/25/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1211 24TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANACORTES
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98221-2557
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-299-1300
Provider Business Mailing Address Fax Number:
360-299-1339

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1213 24TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANACORTES
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98221-2592
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-293-3101
Provider Business Practice Location Address Fax Number:
360-588-1041
Provider Enumeration Date:
09/30/2008

Additional Information

Authorized Official

Authorized Official Last Name:
CUTTER
Authorized Official First Name:
ELISE
Authorized Official Middle Name:
J
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
360-299-1301

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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