N W PEDIATRIC CENTER, INC. P.S. (NPI# 1912515917) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912515917 |
| Entity Type | Organization |
| Organization Name | N W PEDIATRIC CENTER, INC. P.S. |
| Practice Address |
1915 Cooks Hill Rd Centralia WA 98531-9073 |
| Mailing Address |
1911 Cooks Hill Rd Centralia WA 98531-9073 |
| Practice Telephone | 3607366778 |
| Practice Fax Number | 3607366552 |
| Mailing Telephone | 3607366778 |
| Mailing Fax Number | 3607366552 |
| Enumeration Date | 2020-07-16 |
| Last Update Date | 2020-07-16 |
| Authorized Official Name | LISA G MCKAY (PRACTICE MANAGER) |
| Authorized Official Telephone | 3607366778 |
| Is Organization Subpart | Y |
| Parent Organization Name | N W PEDIATRIC CENTER, INC. P.S. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| N | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Northwest Pediatric Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891215182 | N W Pediatric Center, Inc. P.s. | Case Manager/Care Coordinator | 1911 Cooks Hill Rd, Centralia, WA 98531-9073 | 2017-06-27 |
| 1194091637 | N W Pediatric Center, Inc. P.s. | Dietitian, Registered | 18313 Paulson St Sw, Rochester, WA 98579-9262 | 2012-03-29 |
| Street Address |
1915 COOKS HILL RD |
| City | CENTRALIA |
| State | WA |
| Zip Code | 98531-9073 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306462205 | Jelisa Renae Thomas | Counselor | 3510 Steelhammer Ln, Centralia, WA 98531 | 2020-06-17 |
| 1205498607 | Jennifer Kristine Mcglynn Paterno | Counselor | 2428 W. Reynods Ave, Centralia, WA 98531 | 2019-07-05 |
| 1538646328 | Adam Jeffrey Moore | Counselor | 3510 Steelhammer Lane, Centralia, WA 98531 | 2018-07-24 |
| 1144706698 | Euijeong Kim | Occupational Therapist | Rehabilitation Therapies, 914 S. Scheuber Rd, Centralia, WA 98531 | 2018-07-18 |
| 1104315266 | Margaret Fowler Floyd | Registered Nurse | Centralia High School, 813 Eshom Road, Centralia, WA 98531 | 2018-05-04 |
| 1124545777 | Samantha Michelle Moody | Speech-Language Pathologist | Centralia School District, 2320 Borst Ave, Centralia, WA 98531 | 2017-08-24 |
| 1821520289 | Alexa Franks | Behavior Technician | 2428 West Reynolds Ave., Centralia, WA 98531 | 2017-04-03 |
| 1023559861 | Brandy Michelle Peterson | Counselor | 135 W. Main Steet, Centralia, WA 98531 | 2017-03-13 |
| 1841738812 | Graceful Healing Naturopathic | Naturopath | 219 N Tower Ave, Suite 304, Centralia, WA 98531 | 2017-02-09 |
| 1043681513 | Angela Naillon | Counselor | 2428 West Reynolds, Centralia, WA 98531 | 2015-10-09 |
| Find all providers in zip 98531 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| 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/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669678207 | Daniel W Kowals | Pediatrics | 220 Wahington Way, Centralia, WA 98531-9325 | 2007-06-21 |
| 1265594196 | Joseph W Wiley | Pediatrics | 1911 Cooks Hill Rd., Centralia, WA 98531 | 2006-12-15 |
| 1619990678 | Isaac S Pope | Pediatrics | 230 Washington Way, Centralia, WA 98531-9325 | 2006-07-25 |
| 1043218837 | Matthew Tolman Stedelin | Pediatrics | 130 S Lincoln Blvd, Centralia, IL 62801-3654 | 2005-07-14 |
| 1477789956 | Northwest Pediatric Center, Inc. P.s. | Pediatrics | 1911 Cooks Hill Rd, Centralia, WA 98531-9073 | 2009-06-10 |
| 1730370651 | Maria Rowena Carreon Ramirez | Pediatrics | 1911 Cooks Hill Rd, Centralia, WA 98531-9073 | 2007-08-06 |
| 1962521435 | Jennifer Caserta | Pediatrics | 1911 Cooks Hill Rd, Centralia, WA 98531-9073 | 2007-03-28 |
| 1851453773 | Jemima H. Tso | Pediatrics | 1911 Cooks Hill Rd, Centralia, WA 98531-9073 | 2006-12-15 |
| 1114089026 | Jennifer A Polley | Pediatrics | 1911 Cooks Hill Rd., Centralia, WA 98531 | 2006-12-15 |
| 1366504243 | Lily L. Lo | Pediatrics | 1911 Cooks Hill Rd, Centralia, Centralia, WA 98531-9073 | 2006-12-15 |
| Find all providers in CENTRALIA | ||||
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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.