Organization
BLACK HILLS PEDIATRICS INC PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANET NESS (OFFICE MANAGER)
(360) 754-1629
Entity
Organization
Contact information
Practice address
2112 CATON WAY SW, OLYMPIA, WA 98502-1105
(360) 754-1629
(360) 754-1694
Mailing address
2112 CATON WAY SW, OLYMPIA, WA 98502-1105
(360) 754-1629
(360) 754-1694
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1030576
—
WA
Enumeration date
06/16/2008
Last updated
04/11/2013
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