Westside Pediatric Clinic Pc

LBN: Westside Pediatric Clinic Pc
Westside Pediatric Clinic Pc is an health care organization with primary practice located at 9555 Sw Barnes Rd Suite 270, Portland OR 97225. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as the primary health care specialty. Westside Pediatric Clinic Pc can be contacted via phone (503) 297-1025, or through Distefano, Connie Lynn via phone (503) 297-1025.

Contact Information

Primary practice address
9555 Sw Barnes Rd Suite 270 Portland OR 97225
Phone: (503) 297-1025
Fax: (503) 297-1043
Website:
Map and Directions
Authorized official contact:
Name: Distefano, Connie Lynn
Phone: (503) 297-1025

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X

Profile Details

NPI number 1093929226
LBN Legal business name Westside Pediatric Clinic Pc
DBA Doing business as
Authorized official Distefano, Connie Lynn
Entity Organization
Organization subpart 1 No
Enumeration date May 9th, 2007
Last updated Apr 11th, 2008 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093929226 NPPES
Oregon MEDICAID 150220

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