Provider Demographics
NPI:1114213121
Name:PUBLIC HOSPITAL DISTRICT NO 2 SKAGIT COUNTY WASHINGTON
Entity Type:Organization
Organization Name:PUBLIC HOSPITAL DISTRICT NO 2 SKAGIT COUNTY WASHINGTON
Other - Org Name:ORCAS MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ELISE
Authorized Official - Middle Name:J
Authorized Official - Last Name:CUTTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-299-1301
Mailing Address - Street 1:7 DEYE LN
Mailing Address - Street 2:
Mailing Address - City:EASTSOUND
Mailing Address - State:WA
Mailing Address - Zip Code:98245-8578
Mailing Address - Country:US
Mailing Address - Phone:360-376-2561
Mailing Address - Fax:360-376-5183
Practice Address - Street 1:7 DEYE LN
Practice Address - Street 2:
Practice Address - City:EASTSOUND
Practice Address - State:WA
Practice Address - Zip Code:98245-8578
Practice Address - Country:US
Practice Address - Phone:360-376-2561
Practice Address - Fax:360-376-5183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-28
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA508558Medicare Oscar/Certification