Healthcare Provider Details

I. General information

NPI: 1184615627
Provider Name (Legal Business Name): WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2005
Last Update Date: 07/20/2023
Certification Date: 07/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 SE CABOT DR SUITE B101
OAK HARBOR WA
98277-3715
US

IV. Provider business mailing address

PO BOX 24789
SEATTLE WA
98124-0789
US

V. Phone/Fax

Practice location:
  • Phone: 360-679-4121
  • Fax: 360-675-3091
Mailing address:
  • Phone: 360-678-7656
  • Fax: 360-678-3858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

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