Organization
PEDIATRIC CRITICAL CARE ASSOCIATES PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER W GRAVES MD (SECRETERY TRESURER)
(509) 474-5233
Entity
Organization
Contact information
Practice address
101 W 8TH AVE, SPOKANE, WA 99204-2307
(509) 474-7461
(509) 474-5233
Mailing address
PO BOX 84301, SEATTLE, WA 98124-5601
(509) 926-1770
(509) 228-9542
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7055130
—
WA
05
—
7108640
—
WA
Enumeration date
05/11/2006
Last updated
07/12/2007
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