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CHILDRENS CLINIC PC NPI 1649219411


NPI Information

NPI: 1649219411
Provider Name: CHILDRENS CLINIC PC
Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
9555 SW BARNES RD
STE 301
PORTLAND, OR
ZIP 97225
Phone: (503) 297-3371
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CHILDRENS CLINIC PC is a pediatrics in Portland, 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 1649219411. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

9555 SW BARNES RD
STE 301
PORTLAND, OR
ZIP 97225-663
Phone: (503) 297-3371
Fax: (503) 297-7975

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 enumeration date for this NPI number is 6/6/2006 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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther 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: 4/28/2024

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