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BAINBRIDGE PEDIATRICS PLLC NPI 1851424931


NPI Information

NPI: 1851424931
Provider Name: BAINBRIDGE PEDIATRICS, PLLC

Former Legal Business Name: CWW PLLC

Classification: Pediatrics - 2080A0000X
Entity Type: Organization

Specialization: Adolescent Medicine

CLIA Number: 50D1063091

Address:
1298 GROW AVE NW
BAINBRIDGE ISLAND, WA
ZIP 98110
Phone: (206) 780-5437
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BAINBRIDGE PEDIATRICS, PLLC is an adolescent medicine pediatrics in Bainbridge Island, WA. The provider is a pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. BAINBRIDGE PEDIATRICS, PLLC NPI is 1851424931. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Cww Pllc.

The provider's business location address is:

1298 GROW AVE NW
BAINBRIDGE ISLAND, WA
ZIP 98110
Phone: (206) 780-5437
Fax: (206) 780-5438

The provider's authorized official is Jennifer M. Ottmer .
The authorized official title is Practice Manager and has the following contact phone number (206) 780-5437.

The CLIA number assigned to this NPI record is 50D1063091 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/14/2007 and was last updated on 1/16/2018.


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
12080A0000XPediatricsAdolescent Medicine602636742WASHINGTONYes

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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