Organization
PUBLIC HOSPITAL DIST NO 1 SKAGIT
Active
Other names
Cascade Valley Hospital Physicians
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL ISHIZUKA (CHIEF FINANCIAL OFFICER)
(360) 814-5838
Entity
Organization
Contact information
Practice address
330 S STILLAGUAMISH AVE, ARLINGTON, WA 98223-1642
(360) 435-2133
(360) 435-0513
Mailing address
1400 E KINCAID ST, ATTN: CREDENTIALING, MOUNT VERNON, WA 98274-4127
(360) 428-2500
(360) 428-6485
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
00000106
WA
207LP2900X
Pain Medicine (Anesthesiology) Physician
00000106
WA
207R00000X
Internal Medicine Physician
00000106
WA
208M00000X
Hospitalist Physician
HAC.FS.00000106
WA
367500000X
Certified Registered Nurse Anesthetist
000000106
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2061042
—
WA
01
—
355079
LABOR & INDUSTRIES
WA
Enumeration date
05/14/2012
Last updated
07/21/2022
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