PEDIATRIC CLINIC NPI 1952561805

NPI Information

  • NPI: 1952561805
  • Provider Name: PEDIATRIC CLINIC
  • Classification: Point of Service - 305S00000X
  • Entity Type: Organization
  • CLIA Number: 50D2208710
  • Address: 32124 1ST AVE S STE 100
    FEDERAL WAY, WA
    ZIP 98003
  • Phone: (253) 661-5939

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NPI Details

PEDIATRIC CLINIC is a point of service in Federal Way, WA. The provider is this product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. PEDIATRIC CLINIC NPI is 1952561805. The provider is registered as an organization entity type.

The provider's business location address is:

32124 1ST AVE S STE 100
FEDERAL WAY, WA
ZIP 98003-761
Phone: (253) 661-5939
Fax: (253) 661-5929

The provider's authorized official is Mohinder Singh Badyal .
The authorized official title is Physician and has the following contact phone number (253) 661-5939.

The CLIA number assigned to this NPI record is 50D2208710 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/13/2008 and was last updated on 6/13/2008.

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
1305S00000XPoint of ServiceMD00031337WASHINGTONYes

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
17056443MEDICAIDWASHINGTON

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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