MEDICARE: SKAGIT PATHOLOGY, INC, PS

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
1	291U00000X	Clinical Medical Laboratory		WA

General Provider Information

NPI Number	:	1801972377
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SKAGIT PATHOLOGY, INC, PS

Provider Business Mailing Address
First Line	:	1310 E DIVISION ST
Second Line	:
City	:	MOUNT VERNON
State	:	WA
Zip	:	98274-4133
Country	:	US
Telephone Number	:	360-416-2218
Fax Number	:	360-416-2287

Provider Business Practice Location Address
First Line	:	1310 E DIVISION ST
Second Line	:
City	:	MOUNT VERNON
State	:	WA
Zip	:	98274-4133
Country	:	US
Telephone Number	:	360-416-2218
Fax Number	:	360-416-2287

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DARYL G VOGEL
Credential	:	M.D.
Telephone Number	:	360-416-2216

Provider Enumeration Date	:	10/27/2006
Last Update Date	:	08/22/2020

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