Provider Demographics
NPI:1982116901
Name:WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICT
Other - Org Name:WHIDBEYHEALTH PRIMARY CARE - CABOT
Other - Org Type:Other Name
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:GARTH
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-678-7656
Mailing Address - Street 1:275 SE CABOT DR STE B101
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-3740
Mailing Address - Country:US
Mailing Address - Phone:360-675-6648
Mailing Address - Fax:360-679-2487
Practice Address - Street 1:275 SE CABOT DR STE B101
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-3740
Practice Address - Country:US
Practice Address - Phone:360-675-6648
Practice Address - Fax:360-679-2487
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-10-31
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health