There is an outpatient clinic in Mt. Vernon (next county over) and Island Transit will get you over to Skagit County.

You may also want to look at Thurston County, which offers a lot of the same rural/semi rural options as Island County, along with the functional transit system you described wanting, and easy access to VA facilities, without being stuck on an island where the only way off is a bridge or two ferries. (Grew up there, it's a great place to retire, but just disconnected enough from the rest of the world to get to you after a while).

With the direction that IL is heading, which is a regress in gun controls, I would say your thoughts on WA aren't a better situation in that aspect. Now that IL has concealed carry and still has no state registration, it's seemed to me that some aspects of firearm ownership has become easier. Here we have state registration for pistols bought from or transferred through an FFL. You still have the FOID, no fullauto, SBS, or SBR in the state but, in the time since I left, it seems the good fight has been paying off in small dividends instead of a lump sum. Since I moved here, I've seen more controls instituted, despite the allowance of SBR, SBS. Seattle recently passed a guns and ammo tax and has driven out at least one of the retail FFLs from the city to a location outside the city. Still not as bad as finding a brick and mortar FFL in Chicago though.

I, like you had this area on my radar partially based on gun laws. Some of thse liberties aren't legally available anymore, and I've only been here three and half years.

Now onto some positives. Never have in my life, and having moved numerous times and lived in three states prior, have I ever had the amount of gun shops and places to shoot available to me within an hour or less. You can fill up your weekend with shooting matches all year here. You can drive off in the the woods on public land and throw lead downrange until your heart is content or until you run out of ammo. You need 1911 parts? There's shop for that. You need AR parts? There's a shop for that. You need a selection of 60 year old rifles? There's a shop for that. You want to run into one of the forum admins on public transportation? That happens. You want to make friends and see how people will reach out and stick their neck way out for you, a stranger? That happens too.

This seven year old Merlot is tasty.

There is no formalized handgun registration like in Illinois in WA. There is a set of paperwork that is retained on file when a pistol is purchased through a dealer, but there is no requirement to have your guns registered with the state. It's more a de facto registry than a formal one.