Wild Rose Pediatrics LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

WILD ROSE PEDIATRICS LLC

Practice address

629 E 8TH St
Port Angeles, WA 98362-6223

Phone

(360) 775-4640

NPI assigned

Jun 30, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Christine Rose, MDNPI 1184843377

Title

Owner

Phone

(306) 775-4640

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Christine Marie Rose, MD

  • Pediatrics Physician
  • Port Angeles, WA
  • NPI 1184843377
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1688083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688083200000",
    "number": "1033896048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 E 8TH ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983626223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 E 8TH ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983626223",
            "telephone_number": "360-775-4640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILD ROSE PEDIATRICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-30",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A",
        "authorized_official_last_name": "ROSE",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "306-775-4640",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Holley Whitley, MD
• Charles Edward Whitmire
• Lynn Whitmore, RN
• Stacie Whitworth
• Wholehearted Functional Medicine
• Michael Wiley
• Brandy Lee Wilkinson
• Gabryelle Yvonne Willard
• Steven Willden, PHARM.D.
• William N Hobbs MD PS

• Pediatrics Physician in Port Angeles, WA
• Providers in Port Angeles, WA by specialty
• Pediatrics Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.