Organization
PUBLIC HOSPITAL DIST NO 1 SKAGIT
Active
Parent organization
PUBLIC HOSPITAL DIST NO 1 SKAGIT
Other names
Skagit Valley Hospital Neurodevelopmental Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
PUBLIC HOSPITAL DIST NO 1 SKAGIT
Authorized official
PAUL ISHIZUKA (CHIEF FINANCIAL OFFICER)
(360) 814-5838
Entity
Organization
Contact information
Practice address
1415 E KINCAID ST, MOUNT VERNON, WA 98274-4126
(360) 814-8382
Mailing address
1400 E KINCAID ST, ATTN: CREDENTIALING, MOUNT VERNON, WA 98274-4127
(360) 814-6724
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
H-207
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2024212
—
WA
Enumeration date
11/19/2012
Last updated
12/06/2017
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