NPIMap

Organization Active NPI

Public Hospital Dist No 1 Skagit

  • Family Medicine Physician
  • Arlington, WA
National Provider Identifier
1497163448
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PUBLIC HOSPITAL DIST NO 1 SKAGIT
Practice address
3823 172ND St NE
Arlington, WA 98223-7735
Phone
(360) 618-5000
NPI assigned
Jul 22, 2014
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Paul Ishizuka
Title
Chief Financial Officer
Phone
(360) 814-5838

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X NU
Physician Assistant 363A00000X NU
Nurse Practitioner 363L00000X NU
Emergency Medicine Physician 207P00000X NU
Family Medicine Physician 207Q00000X NU Primary
Internal Medicine Physician 207R00000X NU
Occupational Medicine Physician 2083X0100X NU
Urology Physician 208800000X NU

Addresses

Primary practice location

3823 172ND St NE
Arlington, WA 98223-7735

Mailing address

1400 E Kincaid St
Attn: Credentialing
Mount Vernon, WA 98274-4127
Phone (360) 814-6724

Other identifiers 2

IdentifierTypeStateIssuer
2040133MedicaidWA
2007916MedicaidWA

Other names 1

  • Skagit Regional Clinics - Smokey Point Other name

National Provider Directory

National Provider Directory
Tax ID family
Public Hospital District No26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1405987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1497163448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E KINCAID ST",
            "address_2": "ATTN: CREDENTIALING",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744127",
            "telephone_number": "360-814-6724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3823 172ND ST NE",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982237735",
            "telephone_number": "360-618-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUBLIC HOSPITAL DIST NO 1 SKAGIT",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-22",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "ISHIZUKA",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "360-814-5838"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2040133",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2007916",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Skagit Regional Clinics - Smokey Point",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Arlington, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.