# WHIDBEY ISLAND MANOR, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Whidbey Island Manor
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063591998
- **Authorized official:** MARK S. WIGGINS (ADMINISTRATOR/CEO)
- **Authorized official phone:** (360) 675-5913

## Contact information

- **Practice address:** 235 SW 6TH AVE, OAK HARBOR, WA 98277-1900
- **Practice address phone:** (360) 675-5913
- **Mailing address:** PO BOX 1900, OAK HARBOR, WA 98277-1900
- **Mailing address phone:** (360) 675-5913

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 4148102 | WA | Yes |

## Other

- **Enumeration date:** 11/02/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 4148102 | — | WA |