Provider Demographics
NPI:1427229186
Name:WGH PRIMARY CARE ASSOCIATES, P.S.
Entity Type:Organization
Organization Name:WGH PRIMARY CARE ASSOCIATES, P.S.
Other - Org Name:WHIDBEY COMMUNITY PHYSICIANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:K
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-675-6648
Mailing Address - Street 1:275 SE CABOT DR
Mailing Address - Street 2:SUITE B101
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-3715
Mailing Address - Country:US
Mailing Address - Phone:360-675-6648
Mailing Address - Fax:360-679-9310
Practice Address - Street 1:275 SE CABOT DR
Practice Address - Street 2:SUITE B101
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-3715
Practice Address - Country:US
Practice Address - Phone:360-675-6648
Practice Address - Fax:360-679-9310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-20
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7141013Medicaid
WAG8871187Medicare PIN