Provider Demographics
NPI:1356528913
Name:SKAGIT VALLEY MEDICAL CENTER INC, PS DBA PACIFIC NORTHWEST CARDIOLOGY
Entity type:Organization
Organization Name:SKAGIT VALLEY MEDICAL CENTER INC, PS DBA PACIFIC NORTHWEST CARDIOLOGY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:BOND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:360-428-2500
Mailing Address - Street 1:307 S 13TH ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98274-4100
Mailing Address - Country:US
Mailing Address - Phone:360-336-9757
Mailing Address - Fax:360-336-2088
Practice Address - Street 1:307 S 13TH ST
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98274-4100
Practice Address - Country:US
Practice Address - Phone:360-336-1609
Practice Address - Fax:360-336-2088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-25
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty