Organization
PEDIATRIC SPECIALISTS OF PENDLETON, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN PLATT (OFFICE MANAGER)
(541) 276-0250
Entity
Organization
Contact information
Practice address
2461 SW PERKINS AVE, PENDLETON, OR 97801-4301
(514) 276-0250
(541) 276-0253
Mailing address
2461 SW PERKINS AVE, PENDLETON, OR 97801-4301
(514) 276-0250
(541) 276-0253
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500612592
—
OR
Enumeration date
12/10/2009
Last updated
05/03/2013
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