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Organization

NORTHWEST PEDIATRIC GASTROENTEROLOGY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DEBRA P SCHULZ (CLINIC MANAGER)
(503) 281-5139
Entity
Organization

Contact information

Practice address
300 N GRAHAM ST, SUITE 420, PORTLAND, OR 97227-1683
(503) 281-5139
(503) 249-3782
Mailing address
300 N GRAHAM ST, SUITE 420, PORTLAND, OR 97227-1683
(503) 281-5139
(503) 249-3782

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
OREGON
OR
05
WASHINGTON
WA
Enumeration date
06/28/2007
Last updated
07/14/2008
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