Organization
PEDIATRIC CLINIC, INC., P.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CINDY A STRANDBERG (OFFICE ADMINISTRATOR)
(360) 425-6117
Entity
Organization
Contact information
Practice address
784 14TH AVE, LONGVIEW, WA 98632-2315
(360) 425-6117
(360) 636-1297
Mailing address
784 14TH AVE, LONGVIEW, WA 98632-2315
(360) 425-6117
(360) 425-8557
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
600024847
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7851702
—
WA
Enumeration date
08/25/2006
Last updated
01/13/2011
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