NORTHWEST PEDIATRIC CRITICAL CARE PC NPI 1013954189

NPI Information

  • NPI: 1013954189
  • Provider Name: NORTHWEST PEDIATRIC CRITICAL CARE PC
  • Classification: Pediatrics - 2080P0203X
  • Specialization: Pediatric Critical Care Medicine
  • Entity Type: Organization
  • CLIA Number: 38D0964893
  • Address: 2801 N GANTENBEIN AVE
    PORTLAND, OR
    ZIP 97227
  • Phone: (503) 413-2794

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NPI Details

NORTHWEST PEDIATRIC CRITICAL CARE PC is a pediatric critical care medicine pediatrics in Portland, OR. The provider is a pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. NORTHWEST PEDIATRIC CRITICAL CARE PC NPI is 1013954189. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2801 N GANTENBEIN AVE
PORTLAND, OR
ZIP 97227
Phone: (503) 413-2794
Fax: (503) 413-6449

The provider's authorized official is Christopher Phillips .
The authorized official title is Billing Manager and has the following contact phone number (360) 567-3284.

The CLIA number assigned to this NPI record is 38D0964893 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 5/31/2006 and was last updated on 7/3/2008.

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
12080P0203XPediatricsPediatric Critical Care MedicineYes

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
1R100739MEDICARE PINOREGON
2051895000OTHEROREGONBLUE CROSS
37085467MEDICAIDWASHINGTON

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: 11/21/2025

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