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Contact Information

PEDIATRIC CARDIOLOGY CENTER OF OREGON PC
971 11TH AVE
LONGVIEW, WA98632-2503
 Phone: 360-667-3049
 Fax: 360-666-0466
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Cardiology

2080P0202X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for PEDIATRIC CARDIOLOGY CENTER OF OREGON PC

NPI # 1528366986
LBN Legal business name PEDIATRIC CARDIOLOGY CENTER OF OREGON PC
Authorized official AMANDA LAMB - (BUSINESS ADMINISTRATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 03/09/2011
Last updated 07/18/2022 - About 4 years ago
Identifiers
WA License # MD00026664
OR Medicaid 231812
OR Other 057775000 REGENCE BLUE CROSS BLUE SHIELD OF OREGON
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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