Organization
PARKVIEW PEDIATRICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JILL ANN DUDIK BROSS MD FAAP (OWNER/PHYSICIAN)
(509) 766-9450
Entity
Organization
Contact information
Practice address
615 S DIVISION ST, MOSES LAKE, WA 98837-3800
(509) 766-9450
(509) 766-1954
Mailing address
615 S DIVISION ST, MOSES LAKE, WA 98837-3800
(509) 766-9450
(509) 766-1954
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD00026434
WA
208000000X
Pediatrics Physician
MD0025968
WA
208000000X
Pediatrics Physician
MD60174015
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7112600
—
WA
Enumeration date
06/23/2005
Last updated
12/24/2012
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