NPIMap

Organization Active NPI

Public Hospital Distrist No. 1 of Snohomish County

Doing business as Valley General Hospital Wound Care Clinic

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Monroe, WA
National Provider Identifier
1063657377
Registry record updated Dec 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianTaxonomy code 2083P0011X
Legal business name
PUBLIC HOSPITAL DISTRIST NO. 1 OF SNOHOMISH COUNTY
Doing business as
Valley General Hospital Wound Care Clinic
Practice address
14701 179TH Ave SE
Monroe, WA 98272-1108
Phone
(360) 794-1447
Fax
(360) 794-1427
NPI assigned
Dec 16, 2008
Last updated
Dec 22, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
PUBLIC HOSPITAL DISTRICT NO. 1 OF SNOHOMISH COUNTYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 22, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Debra S Barker
Title
Credentialing
Phone
(360) 794-1447

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician 2083P0011X NU Primary

Addresses

Primary practice location

14701 179TH Ave SE
Monroe, WA 98272-1108

Mailing address

14701 179TH Ave SE
Monroe, WA 98272-1108
Phone (360) 794-1447

Other identifiers 1

IdentifierTypeStateIssuer
G001255800OtherWAMEDICARE PTAN#

Other names 1

  • Valley General Hospital Wound Care Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Valley General Hospital5 organizations share this tax ID, including this one
Part of
Valley General Hospital

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1229385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229904000000",
    "number": "1063657377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14701 179TH AVE SE",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "982721108",
            "telephone_number": "360-794-1447",
            "fax_number": "360-794-1427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14701 179TH AVE SE",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "982721108",
            "telephone_number": "360-794-1447",
            "fax_number": "360-794-1427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUBLIC HOSPITAL DISTRIST NO. 1 OF SNOHOMISH COUNTY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PUBLIC HOSPITAL DISTRICT NO. 1 OF SNOHOMISH COUNTY",
        "enumeration_date": "2008-12-16",
        "last_updated": "2008-12-22",
        "status": "A",
        "authorized_official_last_name": "BARKER",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "360-794-1447",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2083P0011X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN#",
            "identifier": "G001255800",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley General Hospital Wound Care Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Monroe, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.