Provider Demographics
NPI:1679803126
Name:PUBLIC HOSPITAL DISTRICT NO 1 OF MASON COUNTY
Entity Type:Organization
Organization Name:PUBLIC HOSPITAL DISTRICT NO 1 OF MASON COUNTY
Other - Org Name:MASON GENERAL HOSPITAL MOUNTAIN VIEW WOMEN'S HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECTUIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:APPEL
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:360-427-9556
Mailing Address - Street 1:2300 KATI CT
Mailing Address - Street 2:SUITE A
Mailing Address - City:SHELTON
Mailing Address - State:WA
Mailing Address - Zip Code:98584-1900
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2300 KATI CT
Practice Address - Street 2:SUITE A
Practice Address - City:SHELTON
Practice Address - State:WA
Practice Address - Zip Code:98584-1900
Practice Address - Country:US
Practice Address - Phone:360-426-0955
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-06
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261Q00000X
WA6029267855261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA508551Medicare Oscar/Certification