PEDIATRIC CLINIC, INC., P.S. (NPI# 1639287188) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639287188 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC CLINIC, INC., P.S. |
| Practice Address |
784 14th Ave Longview WA 98632-2315 |
| Practice Telephone | 3604256117 |
| Practice Fax Number | 3606361297 |
| Mailing Telephone | 3604256117 |
| Mailing Fax Number | 3604258557 |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2011-01-13 |
| Authorized Official Name | CINDY A STRANDBERG (OFFICE ADMINISTRATOR) |
| Authorized Official Telephone | 3604256117 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 600024847 | WA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 7851702 | 05 |
| Street Address |
784 14TH AVE |
| City | LONGVIEW |
| State | WA |
| Zip Code | 98632-2315 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083605778 | Daryl William Linnell | Pediatrics | 784 14th Ave, Longview, WA 98632-2315 | 2005-11-02 |
| 1750851846 | Irene Mudehwe | Nurse Practitioner | 784 14th Ave, Longview, WA 98632-2315 | 2018-11-30 |
| 1467940486 | Jeb Bolerjack | Counselor | 784 14th Ave, Longview, WA 98632-2315 | 2018-04-25 |
| 1619418159 | Megan Minthorn | Registered Nurse | 784 14th Ave, Longview, WA 98632-2315 | 2017-03-16 |
| 1962876748 | Cowlitz Family Health Center | Clinic/Center | 784 14th Ave, Longview, WA 98632-2315 | 2015-11-17 |
| 1821340530 | Seth Mercurio | Nurse Practitioner | 784 14th Ave, Longview, WA 98632-2315 | 2012-10-04 |
| 1538357223 | Faith Ann Wilfley | Pediatrics | 784 14th Ave, Longview, WA 98632-2315 | 2007-10-09 |
| 1043238033 | Jan Carlin Khouri | Nurse Practitioner | 784 14th Ave, Longview, WA 98632-2315 | 2006-07-17 |
| 1538147764 | Forrest G Mcgriff | Nurse Practitioner | 784 14th Ave, Longview, WA 98632-2315 | 2006-01-06 |
| 1598756967 | Karen Sachiko Kato | Pediatrics | 784 14th Ave, Longview, WA 98632-2315 | 2005-11-03 |
| 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 | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619274776 | Texas Spine & Joint Hospital Longview Clinic | Clinic/Center | 725 N 4th St, Longview, TX 75601-5412 | 2011-02-24 |
| 1346206786 | Isn Sleep Center of East Texas, LLC | Clinic/Center | 109 W Hoyt Dr, Longview, TX 75601-3614 | 2006-04-25 |
| 1043209919 | Special Health Resources for Texas, Inc | Clinic/Center | 410 N 4th St, Longview, TX 75601-6511 | 2005-10-13 |
| 1487206900 | Etx Chiropractic, Inc | Clinic/Center | 1121 Evergreen St, Longview, TX 75604-2130 | 2019-07-15 |
| 1164930905 | Ideal Option, Pllc | Clinic/Center | 1004 Fir St, Longview, WA 98632-2527 | 2018-01-15 |
| 1932567161 | Spine and Whiplash Center, Inc. | Clinic/Center | 1552 Broadway St, Longview, WA 98632-3716 | 2016-02-02 |
| 1184019184 | Kidspace Therapy, LLC | Clinic/Center | 2145 Tibbetts Dr Ste A, Longview, WA 98632-4211 | 2015-04-06 |
| 1043515091 | Family Focus Wellness Center | Clinic/Center | 101b Woodbine Pl, Longview, TX 75601-2912 | 2011-01-24 |
| 1891012316 | Providence Health & Services - Oregon | Clinic/Center | 625 9th Ave, Suite 120, Longview, WA 98632-2465 | 2010-04-23 |
| 1891010310 | Healthcare Express, LLP | Clinic/Center | 1509 W Loop 281, Longview, TX 75604-2820 | 2010-03-29 |
| Find all providers in LONGVIEW | ||||
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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.