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Northwest Pediatric Center, Inc. P.s.

Northwest Pediatric Center, Inc. P.s. is a health care provider in Centralia, WA. In this page you will find its mailing address, practice location, phone number, specialty etc.

physician-icon Basic Information

Practice Location 300 Ocean Ave, Raymond, WA 98577-3016, US
Practice Location Phone360-736-6778
Practice Location Fax360-736-6552
Legal Business NameNORTHWEST PEDIATRIC CENTER, INC. P.S.
NPI ?1477812741
Entity TypeOrganization
Enumeration Date ? May 8, 2012
Last Update Date ? May 8, 2012
Note:
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).

specialty-icon Specialties & Licenses of Northwest Pediatric Center, Inc. P.s.

SpecialtySpecializationLicenseLicense State
Pediatrics MD00027525Washington
Pediatrics MD00048049Washington
Pediatrics MD00038226Washington
Pediatrics MD00028578Washington

legacy-id-icon Legacy Provider IDs of Northwest Pediatric Center, Inc. P.s.

Provider IdIssuer StateIssuer TypeIssuer
1072958WashingtonMedicaid
8488298WashingtonMedicaid
1058825WashingtonMedicaid
7057375WashingtonMedicaid
8251324WashingtonMedicaid

official-icon Authorized Official of Northwest Pediatric Center, Inc. P.s.

An authorized official is an appointed official with the legal authority to make changes and/or updates to the Northwest Pediatric Center, Inc. P.s.'s status and to commit the provider to fully abide by the laws and regulations relating to the National Provider Identifier (NPI).

Authorized Official Mrs. Lisa Gail Mckay
Authorized Official Title/PositionPRACTICE MANAGER
Authorized Official Phone Number360-623-1161