National Provider Identifier Database

WESTSIDE PEDIATRIC CLINIC PC
Pediatrics

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.


Contact Information

WESTSIDE PEDIATRIC CLINIC PC
9555 SW BARNES RD
SUITE 270
PORTLAND, OR97225
Phone: 503-297-1025
Fax: 503-297-1043
Website:
Specialty Taxonomy Code
* Pediatrics 208000000X

* Indicates primary specialty

NPI Profile & details for WESTSIDE PEDIATRIC CLINIC PC

NPI Number 1093929226
Legal business name
LBN
WESTSIDE PEDIATRIC CLINIC PC
Authorized official CONNIE DISTEFANO - (ADMINISTRATOR)
Entity Organization
Organization subpart No
Enumeration date 05/09/2007
Last updated 04/11/2008 - About 18 years ago
Sole proprietor1 Not specified
Identifiers
  • OR Medicaid: 150220

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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