Healthcare Provider Details

I. General information

NPI: 1821632639
Provider Name (Legal Business Name): WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2019
Last Update Date: 07/20/2023
Certification Date: 07/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 NE GOLDIE ST
OAK HARBOR WA
98277-4832
US

IV. Provider business mailing address

PO BOX 24789
SEATTLE WA
98124-0789
US

V. Phone/Fax

Practice location:
  • Phone: 360-679-5590
  • Fax: 360-675-1440
Mailing address:
  • Phone: 360-678-7656
  • Fax: 866-442-8884

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: GARTH A MILLER
Title or Position: COO
Credential:
Phone: 360-678-7656