Healthcare Provider Details

I. General information

NPI: 1962334862
Provider Name (Legal Business Name): PUBLIC HOSPITAL DIST NO 1 SKAGIT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 S LAVENTURE RD
MOUNT VERNON WA
98274-6033
US

IV. Provider business mailing address

PO BOX 103510
PASADENA CA
91189-3510
US

V. Phone/Fax

Practice location:
  • Phone: 360-424-7041
  • Fax: 360-424-2418
Mailing address:
  • Phone: 360-814-7575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: TAMARA L CESENA
Title or Position: CFO
Credential:
Phone: 360-445-8512