Organization
PUBLIC HOSPITAL DIST NO 1 SKAGIT
Active
Other names
Skagit Valley Kidney Center
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL ISHIZUKA (CFO)
(360) 814-8346
Entity
Organization
Contact information
Practice address
208 S. HOSPITAL PARKWAY, MOUNT VERNON, WA 98274-4126
(360) 424-4111
Mailing address
1415 E KINCAID ST, ATTN: CREDENTIALING, MOUNT VERNON, WA 98274-4126
(360) 424-4111
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
H-207
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1002366
—
WA
Enumeration date
11/20/2006
Last updated
09/18/2018
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