Healthcare Provider Details

I. General information

NPI: 1073554903
Provider Name (Legal Business Name): PUBLIC HOSPITAL DIST NO 1 SKAGIT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

903 MEDICAL CENTER DR
ARLINGTON WA
98223-1697
US

IV. Provider business mailing address

PO BOX 103510
PASADENA CA
91189-3570
US

V. Phone/Fax

Practice location:
  • Phone: 360-435-0242
  • Fax: 360-435-9135
Mailing address:
  • Phone: 360-814-7575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology 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