Healthcare Provider Details

I. General information

NPI: 1023332749
Provider Name (Legal Business Name): PUBLIC HOSPITAL DIST NO 1 SKAGIT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2010
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 E KINCAID ST
MOUNT VERNON WA
98274-4127
US

IV. Provider business mailing address

PO BOX 103510
PASADENA CA
91189-3570
US

V. Phone/Fax

Practice location:
  • Phone: 360-428-2500
  • Fax: 360-424-2522
Mailing address:
  • Phone: 360-814-7575
  • Fax: 360-445-8592

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

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