| Pediatric Clinic, Inc., P.s. | |
|
784 14th Ave Longview WA 98632-2315 | |
| (360) 425-6117 | |
| (360) 636-1297 |
| Full Name | Pediatric Clinic, Inc., P.s. |
|---|---|
| Speciality | Clinic/center |
| Location | 784 14th Ave, Longview, Washington |
| Authorized Official Name and Position | Cindy A Strandberg (OFFICE ADMINISTRATOR) |
| Authorized Official Contact | 3604256117 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Clinic, Inc., P.s. 784 14th Ave Longview WA 98632-2315 Ph: (360) 425-6117 | Pediatric Clinic, Inc., P.s. 784 14th Ave Longview WA 98632-2315 Ph: (360) 425-6117 |
| NPI Number | 1639287188 |
|---|---|
| Provider Enumeration Date | 08/25/2006 |
| Last Update Date | 01/13/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639287188 | NPI | - | NPPES |
| 7851702 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 600024847 (Washington) | Primary |
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