Provider Demographics
NPI:1508961046
Name:PUBLIC HOSPITAL DISTRICT 304 SKAGIT CTY WA
Entity Type:Organization
Organization Name:PUBLIC HOSPITAL DISTRICT 304 SKAGIT CTY WA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GREG
Authorized Official - Middle Name:C
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-856-7112
Mailing Address - Street 1:2000 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:SEDRO WOOLLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98284-4327
Mailing Address - Country:US
Mailing Address - Phone:360-856-6021
Mailing Address - Fax:360-856-7300
Practice Address - Street 1:2000 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:SEDRO WOOLLEY
Practice Address - State:WA
Practice Address - Zip Code:98284-4327
Practice Address - Country:US
Practice Address - Phone:360-856-6021
Practice Address - Fax:360-856-7300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0177558OtherLABOR AND INDUSTRIES
WA612706011OtherGROUP HEALTH
WA7119753Medicaid
WA7119753Medicaid