Provider Demographics
NPI:1609957232
Name:WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICT
Other - Org Name:WHIDBEYHEALTH ORTHOPEDIC CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:GARTH
Authorized Official - Middle Name:A
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-678-7656
Mailing Address - Street 1:PO BOX 24789
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-0789
Mailing Address - Country:US
Mailing Address - Phone:360-678-7656
Mailing Address - Fax:360-678-3858
Practice Address - Street 1:205 S MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:COUPEVILLE
Practice Address - State:WA
Practice Address - Zip Code:98239-3635
Practice Address - Country:US
Practice Address - Phone:360-240-4013
Practice Address - Fax:360-678-5161
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-18
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8862175Medicare PIN