PEDIATRIC CARDIOLOGY CENTER OF OREGON PC (NPI# 1528366986) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528366986 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC CARDIOLOGY CENTER OF OREGON PC |
| Practice Address |
971 11th Ave Longview WA 98632-2503 |
| Mailing Address |
Po Box 821350 Vancouver WA 98682-0030 |
| Practice Telephone | 3606673049 |
| Practice Fax Number | 3606660466 |
| Mailing Telephone | 3606673049 |
| Mailing Fax Number | 3606660466 |
| Enumeration Date | 2011-03-09 |
| Last Update Date | 2020-10-21 |
| Authorized Official Name | AMANDA L. LAMB (BUSINESS ADMINISTRATOR) |
| Authorized Official Telephone | 5032803418 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2080P0202X |
Pediatrics Specialization: Pediatric Cardiology |
MD00026664 | WA | Allopathic & Osteopathic Physicians |
| Y | 2080P0202X |
Pediatrics Specialization: Pediatric Cardiology |
OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | REGENCE BLUE CROSS BLUE SHIELD OF OREGON | 057775000 | 01 |
| OR | 231812 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144287541 | Pediatric Cardiology Center of Oregon PC | Pediatrics | 300 N Graham St, Suite 250, Portland, OR 97227-1683 | 2006-04-28 |
| Street Address |
971 11TH AVE |
| City | LONGVIEW |
| State | WA |
| Zip Code | 98632-2503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750362943 | Hannah G Rishel | Pediatrics | 971 11th Ave, Longview, WA 98632 | 2005-11-07 |
| 1134657778 | Child and Adolescent Clinic | Case Manager/Care Coordinator | 971 11th Ave, Longview, WA 98632-2503 | 2017-05-26 |
| 1730564378 | Robin Wulff | Nurse Practitioner | 971 11th Ave, Longview, WA 98632-2503 | 2015-07-24 |
| 1457765638 | Jennifer Chu-smith | Pediatrics | 971 11th Ave, Longview, WA 98632-2503 | 2014-06-16 |
| 1467866939 | Jennifer Christine Hollinger | Pediatrics | 971 11th Ave, Longview, WA 98632 | 2014-06-12 |
| 1215222591 | Susanna R Mirel | Nurse Practitioner | 971 11th Ave, Longview, WA 98632-2503 | 2011-06-14 |
| 1801195375 | Wesley Scott Henricksen | Pediatrics | 971 11th Ave, Longview, WA 98632-2503 | 2011-03-22 |
| 1538303458 | Tsering L Lhewa | Pediatrics | 971 11th Ave, Longview, WA 98632-2503 | 2009-04-22 |
| 1932363124 | Amrita Stark | Pediatrics | 971 11th Ave, Longview, WA 98632-2503 | 2008-07-16 |
| 1104097906 | Providence Health & Services Oregon | Clinic/Center | 971 11th Ave, Longview, WA 98632-2503 | 2008-03-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851992366 | Honor Senior Care LLC | Home Health Aide | 1135 3rd Ave, Ste S101, Longview, WA 98632 | 2020-11-03 |
| 1417416728 | Sam Wise | Dentist | 1538 11th Ave Lowr Columbia, Longview, WA 98632 | 2019-03-16 |
| 1053870717 | Matthew Johnson | Physician Assistant | 900 Ocean Beach Hwy Ste 110, Longview, WA 98632 | 2019-03-12 |
| 1295205367 | Abid Valji | Occupational Therapist | Americana Health and Rehabilitation Center, 917 7th Ave, Longview, WA 98632 | 2018-11-30 |
| 1184106437 | Peacehealth | Durable Medical Equipment & Medical Supplies | Triangle Mall Suite 16 1015 Ocean Beach Hwy, Longview, WA 98632 | 2018-09-04 |
| 1982186318 | Linda Joan Mason | Licensed Practical Nurse | 1153 23rd Ave, Longview, WA 98632 | 2018-09-01 |
| 1891291910 | Ellen Sumner Hornbeak | Physical Therapist | 200 Triangle Shopping Ctr Ste 270, Longview, WA 98632 | 2018-04-05 |
| 1700399961 | Johnna Joyce Knapp | Speech-Language Pathologist | 2615 Lilac St, Longview, WA 98632 | 2017-11-09 |
| 1841711868 | Deborah Annette Burzynski | Registered Nurse | 1057 12th Avenue, Longview, WA 98632 | 2017-06-29 |
| 1598291122 | Cheyenne West | Counselor | 1616 10th Avenue, Longview, WA 98632 | 2017-05-02 |
| Find all providers in zip 98632 | ||||
| Taxonomy Code | 2080P0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Cardiology |
| A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760823801 | Ashish Garg | Pediatrics | 112 Columbia Point Dr Ste 103, Richland, WA 99352-4390 | 2013-07-16 |
| 1164690046 | Jason Deen | Pediatrics | 4745 49th Ave Ne, Seattle, WA 98105-3829 | 2008-02-13 |
| 1225215999 | Agustin Eduardo Rubio | Pediatrics | 4800 Sand Point Way Ne Seattle Children's Hospital, Division of Pediatric Cardiology, G-0035, Seattle, WA 98105-3901 | 2008-01-24 |
| 1760685861 | Brian D Soriano | Pediatrics | 4800 Sand Point Way Ne # G-0035, Seattle, WA 98105-3901 | 2007-06-06 |
| 1083775902 | Donald L Trippel | Pediatrics | 1901 S Cedar St Ste 103, Tacoma, WA 98405-2302 | 2006-12-13 |
| 1689068173 | Joshua John Price | Pediatrics | 4800 Sand Point Way Ne, Seattle, WA 98105-3901 | 2015-03-24 |
| 1659787075 | Iman Naimi | Pediatrics | 4800 Sand Point Way Ne, Seattle, WA 98105-3901 | 2014-07-07 |
| 1265859375 | Erik L Frandsen | Pediatrics | 4800 Sand Point Way Ne, Seattle, WA 98105-3901 | 2014-03-26 |
| 1548603301 | Humera Ahmed | Pediatrics | 4800 Sand Point Way Ne, Seattle, WA 98105-3901 | 2013-04-11 |
| 1184966384 | Elizabeth C Caris | Pediatrics | 4800 Sand Point Way Ne, Seattle, WA 98105-3901 | 2013-03-26 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.