Healthcare Provider Details

I. General information

NPI: 1013064575
Provider Name (Legal Business Name): PUBLIC HOSPITAL DIST NO 1 SKAGIT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1190 RIDDLE STREET
DARRINGTON WA
98241
US

IV. Provider business mailing address

PO BOX 103510
PASADENA CA
91189-3570
US

V. Phone/Fax

Practice location:
  • Phone: 360-436-1055
  • Fax: 360-436-0146
Mailing address:
  • Phone: 360-814-7575
  • Fax: 360-445-8592

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License NumberMTSP.FS.00001468
License Number StateWA

VIII. Authorized Official

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