Healthcare Provider Details

I. General information

NPI: 1356528913
Provider Name (Legal Business Name): SKAGIT VALLEY MEDICAL CENTER INC, PS DBA PACIFIC NORTHWEST CARDIOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2008
Last Update Date: 02/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 S 13TH ST
MOUNT VERNON WA
98274-4100
US

IV. Provider business mailing address

307 S 13TH ST
MOUNT VERNON WA
98274-4100
US

V. Phone/Fax

Practice location:
  • Phone: 360-336-1609
  • Fax: 360-336-2088
Mailing address:
  • Phone: 360-336-9757
  • Fax: 360-336-2088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN D BOND
Title or Position: PRESIDENT
Credential: MD
Phone: 360-428-2500