Organization Active NPI

Little Island Pediatrics, LLC

  • Pediatrics Physician
  • Beaverton, OR
National Provider Identifier
1063308955
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
LITTLE ISLAND PEDIATRICS, LLC
Practice address
17200 NW Corridor CT Ste 112
Beaverton, OR 97006-3295
Phone
(503) 966-3757
Fax
(503) 212-0432
NPI assigned
Jun 16, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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

Authorized official

Name
Ling-an Wu, MDNPI 1427499565
Title
Owner
Phone
(503) 966-3757

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

17200 NW Corridor CT Ste 112
Beaverton, OR 97006-3295

Mailing address

17200 NW Corridor CT Ste 112
Beaverton, OR 97006-3295
Phone (503) 966-3757

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
38D2331982Little Island Pediatrics17200 NW Corridor CT, Ste 112, Beaverton, OR 97006Certificate of waiverOct 9, 2027

National Provider Directory

National Provider Directory

Locations

17200 NW Corridor Ct
Ste 112
Beaverton, OR 97006
Phone (503) 439-6969

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1750032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750032000000",
    "number": "1063308955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17200 NW CORRIDOR CT STE 112",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970063295",
            "telephone_number": "503-966-3757",
            "fax_number": "503-212-0432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17200 NW CORRIDOR CT STE 112",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970063295",
            "telephone_number": "503-966-3757",
            "fax_number": "503-212-0432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE ISLAND PEDIATRICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-16",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A",
        "authorized_official_last_name": "WU",
        "authorized_official_first_name": "LING-AN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-966-3757",
        "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": []
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.