Healthcare Provider Details

I. General information

NPI: 1043241540
Provider Name (Legal Business Name): PUBLIC HOSPITAL DISTRICT NO 1 SKAGIT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 WESLEY ST STE 130
ARLINGTON WA
98223-1613
US

IV. Provider business mailing address

PO BOX 103510
PASADENA CA
91189-3570
US

V. Phone/Fax

Practice location:
  • Phone: 360-435-6525
  • Fax: 360-435-2634
Mailing address:
  • Phone: 360-814-7575
  • Fax: 360-445-8592

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License NumberHAC.FS.0000106
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberHAC.FS.00000106
License Number StateWA

VIII. Authorized Official

Name: TAMARA CESENA
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 360-445-8512