MEDICARE: PUBLIC HOSPITAL DIST NO 1 SKAGIT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center	ASF.FS.60651816	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	355079	OTHER	WA	LABOR & INDUSTRIES
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316061765
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PUBLIC HOSPITAL DIST NO 1 SKAGIT

Provider Business Mailing Address
First Line	:	PO BOX 103510
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91189-3510
Country	:	US
Telephone Number	:	360-814-6451
Fax Number	:	360-445-8592

Provider Business Practice Location Address
First Line	:	875 WESLEY ST STE 160
Second Line	:
City	:	ARLINGTON
State	:	WA
Zip	:	98223-1650
Country	:	US
Telephone Number	:	360-435-6969
Fax Number	:	360-435-1068

Authorized Official
Title or Position	:	VP OF OPERATIONS
Name	:	JOLANDA M BARNETT
Credential	:
Telephone Number	:	360-435-2133

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	12/02/2025

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