Healthcare Provider Details

I. General information

NPI: 1245214683
Provider Name (Legal Business Name): ORCAS FAMILY HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1286 MOUNT BAKER RD STE B-102
EASTSOUND WA
98245-8931
US

IV. Provider business mailing address

1286 MOUNT BAKER RD STE B-102
EASTSOUND WA
98245-8931
US

V. Phone/Fax

Practice location:
  • Phone: 360-376-7778
  • Fax: 360-376-7706
Mailing address:
  • Phone: 360-376-7778
  • Fax: 360-376-7706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD00037547
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberWA17180
License Number StateWA

VIII. Authorized Official

Name: DAVID C SHINSTROM
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 360-376-7778