CHILDRENS CLINIC PC NPI 1316137235

NPI Information

  • NPI: 1316137235
  • Provider Name: CHILDRENS CLINIC PC
  • Classification: Pediatrics - 208000000X
  • Entity Type: Organization
  • CLIA Number: 38D0670371
  • Address: 19260 SW 65TH AVE
    STE 340
    TUALATIN, OR
    ZIP 97062
  • Phone: (503) 691-9777

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NPI Details

CHILDRENS CLINIC PC is a pediatrics in Tualatin, OR. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. CHILDRENS CLINIC PC NPI is 1316137235. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

19260 SW 65TH AVE
STE 340
TUALATIN, OR
ZIP 97062-701
Phone: (503) 691-9777
Fax: (503) 692-6736

The provider's authorized official is Kelsey Durham .
The authorized official title is Health Plan Coordinator and has the following contact phone number (503) 535-6314.

The CLIA number assigned to this NPI record is 38D0670371 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 7/26/2007 and was last updated on 4/28/2020.

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
1208000000XPediatricsYes

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
1500730975MEDICAIDOREGON

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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