Organization
PEDIATRIC CARDIOLOGY CENTER OF OREGON PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA L. LAMB (BUSINESS ADMINISTRATOR)
(503) 280-3418
Entity
Organization
Contact information
Practice address
971 11TH AVE, LONGVIEW, WA 98632-2503
(360) 667-3049
(360) 666-0466
Mailing address
PO BOX 821350, VANCOUVER, WA 98682-0030
(360) 667-3049
(360) 666-0466
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
MD00026664
WA
2080P0202X
Pediatric Cardiology Physician
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
057775000
REGENCE BLUE CROSS BLUE SHIELD OF OREGON
OR
05
—
231812
—
OR
Enumeration date
03/09/2011
Last updated
07/18/2022
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