Organization
PARKVIEW PEDIATRICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JILL A DUDIK BROSS MD (PRESIDENT)
(509) 766-9450
Entity
Organization
Contact information
Practice address
615 S DIVISION ST, MOSES LAKE, WA 98837-3800
(509) 766-9450
(509) 765-9407
Mailing address
615 S DIVISION ST, MOSES LAKE, WA 98837-3800
(509) 766-9450
(509) 765-9407
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7590771
—
WA
Enumeration date
04/17/2007
Last updated
09/30/2009
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