Organization
SKAGIT PEDIATRICS, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELIQUE KISSAS (CREDENTIALING SPECIALIST)
(360) 542-1362
Entity
Organization
Contact information
Practice address
2101 LITTLE MOUNTAIN LN, MOUNT VERNON, WA 98274-8752
(360) 428-2622
(360) 428-3941
Mailing address
2101 LITTLE MOUNTAIN LN, MOUNT VERNON, WA 98274-8752
(360) 428-2622
(360) 428-3941
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7235807
—
WA
Enumeration date
03/27/2007
Last updated
07/21/2022
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