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	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1639001530
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	:	360-814-7575
Fax Number	:

Provider Business Practice Location Address
First Line	:	2320 FREEWAY DR
Second Line	:
City	:	MOUNT VERNON
State	:	WA
Zip	:	98273-5445
Country	:	US
Telephone Number	:	360-814-6800
Fax Number	:	360-814-6917

Authorized Official
Title or Position	:	CFO
Name	:	TAMARA L CESENA
Credential	:
Telephone Number	:	360-445-8512

Provider Enumeration Date	:	06/02/2026
Last Update Date	:	06/02/2026

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