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PEDIATRIC CLINIC INC. P.S. NPI 1639287188


NPI Information

NPI: 1639287188
Provider Name: PEDIATRIC CLINIC, INC., P.S.
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
784 14TH AVE
LONGVIEW, WA
ZIP 98632
Phone: (360) 425-6117
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PEDIATRIC CLINIC, INC., P.S. is a clinic center in Longview, WA. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). PEDIATRIC CLINIC, INC., P.S. NPI is 1639287188. The provider is registered as an organization entity type.

The provider's business location address is:

784 14TH AVE
LONGVIEW, WA
ZIP 98632-315
Phone: (360) 425-6117
Fax: (360) 636-1297

The provider's authorized official is Cindy A Strandberg .
The authorized official title is Office Administrator and has the following contact phone number (360) 425-6117.

The enumeration date for this NPI number is 8/25/2006 and was last updated on 1/13/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/Center600024847WASHINGTONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
17851702MEDICAIDWASHINGTON
2AB15232MEDICARE ID-TYPE UNSPECIFIEDWASHINGTONMEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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