Healthcare Provider Details

I. General information

NPI: 1609497858
Provider Name (Legal Business Name): WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2020
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 TERRY AVE UNIT 1003
SEATTLE WA
98101-1982
US

IV. Provider business mailing address

PO BOX 3603
SEATTLE WA
98124-3603
US

V. Phone/Fax

Practice location:
  • Phone: 360-678-5151
  • Fax:
Mailing address:
  • Phone: 360-678-7656
  • Fax: 360-678-0945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

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