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Organization
FOREST GROVE PEDIATRICS PC
Active
Organization
FOREST GROVE PEDIATRICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATHERINE ROSE LONG MD (PHYSICIAN OWNER)
(503) 359-1930
Entity
Organization
Contact information
Practice address
1911 MOUNTAIN VIEW LN, SUITE 200, FOREST GROVE, OR 97116-2382
(503) 359-1930
(503) 359-1985
Mailing address
1911 MOUNTAIN VIEW LN, SUITE 200, FOREST GROVE, OR 97116-2382
(503) 359-1930
(503) 359-1985
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
05/23/2007
Last updated
08/22/2020
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