Healthcare Provider Details

I. General information

NPI: 1609973007
Provider Name (Legal Business Name): SKAGIT COUNTY PUBLIC HOSPITAL DISTRICT NO 304
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 04/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 HOSPITAL DR
SEDRO WOOLLEY WA
98284-4327
US

IV. Provider business mailing address

2000 HOSPITAL DR
SEDRO WOOLLEY WA
98284-4327
US

V. Phone/Fax

Practice location:
  • Phone: 360-856-6021
  • Fax: 360-856-7300
Mailing address:
  • Phone: 360-856-6021
  • Fax: 360-856-7300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. GREG C REED
Title or Position: CEO
Credential:
Phone: 360-856-7112