Organization
NORTHWEST PEDIATRIC CRITICAL CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER PHILLIPS CPC (BILLING MANAGER)
(360) 567-3284
Entity
Organization
Contact information
Practice address
2801 N GANTENBEIN AVE, PORTLAND, OR 97227
(503) 413-2794
(503) 413-6449
Mailing address
PO BOX 821350, VANCOUVER, WA 98682-0030
(866) 622-2455
(360) 666-0466
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051895000
BLUE CROSS
OR
05
—
7085467
—
WA
Enumeration date
05/31/2006
Last updated
07/03/2008
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