Healthcare Provider Details

I. General information

NPI: 1043497001
Provider Name (Legal Business Name): WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2008
Last Update Date: 07/20/2023
Certification Date: 07/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 N MAIN ST
COUPEVILLE WA
98239-3413
US

IV. Provider business mailing address

PO BOX 3603
SEATTLE WA
98124-3603
US

V. Phone/Fax

Practice location:
  • Phone: 360-678-5151
  • Fax: 360-678-7676
Mailing address:
  • Phone: 360-678-5151
  • Fax: 360-678-7676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number State

VIII. Authorized Official

Name: MR. GARTH MILLER
Title or Position: COO
Credential:
Phone: 360-678-7656