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NPI Code Detail

MEDICARE: PUBLIC HOSPITAL DIST NO 1 SKAGIT

MEDICARE: PUBLIC HOSPITAL DIST NO 1 SKAGIT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207XX0005XSports Medicine (Orthopaedic Surgery) Physician
2213ES0103XFoot & Ankle Surgery Podiatrist
3207X00000XOrthopaedic Surgery PhysicianHAC.FS.00000106WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1295774016
Entity Type Code : Organization
Provider Name (Legal Business Name) : PUBLIC HOSPITAL DIST NO 1 SKAGIT
Provider Business Mailing Address
First Line : 1400 E. KINCAID STREET
Second Line : ATTN: CREDENTIALING
City : MOUNT VERNON
State : WA
Zip : 98274-4127
Country : US
Telephone Number : 360-814-6724
Fax Number : 360-428-6485
Provider Business Practice Location Address
First Line : 328 S. STILLAGUAMISH AVE.
Second Line :
City : ARLINGTON
State : WA
Zip : 98223-1660
Country : US
Telephone Number : 360-435-6641
Fax Number : 360-618-7663
Authorized Official
Title or Position : CHIEF FINANCIAL OFFICER
Name : PAUL ISHIZUKA
Credential :
Telephone Number : 360-814-5838
Provider Enumeration Date : 06/06/2006
Last Update Date : 12/10/2018

Similar Medicare Providers

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Practice Location Address:
328 S STILLAGUAMISH AVE
ARLINGTON, WA
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1225079478 — MICHAEL B RIOJAS DPM
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1558466029 — EDWARD W EISSMANN MD
Practice Location Address:
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ARLINGTON, WA
98223-1660
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Practice Fax: 360-618-7663
1639391501 — PAUL NAUMANN
Practice Location Address:
328 S STILLAGUAMISH AVE
ARLINGTON, WA
98223-1660
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1912568205 — ANDREA LYN FELLMAN NP-C
Practice Location Address:
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Practice Fax:

Directions to “PUBLIC HOSPITAL DIST NO 1 SKAGIT ” Practice Location

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