Healthcare Provider Details

I. General information

NPI: 1992827471
Provider Name (Legal Business Name): PUBLIC HOSPITAL DISTRICT NO.1 OF MASON COUNTY WASHINGTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 06/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 NE STATE ROUTE 300
BELFAIR WA
98528-0520
US

IV. Provider business mailing address

PO BOX 520
BELFAIR WA
98528-0520
US

V. Phone/Fax

Practice location:
  • Phone: 360-275-4084
  • Fax:
Mailing address:
  • Phone: 360-427-3439
  • Fax: 360-427-9597

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateWA

VIII. Authorized Official

Name: GEORGE ROBERT APPEL
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 360-427-9549