Basic Information
Provider Information
NPI: 1740922921
EntityType: 2
ReplacementNPI:  
OrganizationName: WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICT
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Mailing Information
Address1: 101 N MAIN ST
Address2:  
City: COUPEVILLE
State: WA
PostalCode: 982393413
CountryCode: US
TelephoneNumber: 3606785151
FaxNumber: 8664428884
Practice Location
Address1: 923 PEACHTREE ST NE
Address2:  
City: ATLANTA
State: GA
PostalCode: 303094458
CountryCode: US
TelephoneNumber: 3606785151
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/08/2022
LastUpdateDate: 04/08/2022
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AuthorizedOfficialLastName: LAYFIELD
AuthorizedOfficialFirstName: MICHAEL
AuthorizedOfficialMiddleName: G
AuthorizedOfficialTitleorPosition: INTERIM CEO
AuthorizedOfficialTelephone: 3606787656
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICT
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NPICertificationDate: 04/08/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800X  Y193400000X MULTIPLE SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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