NPIMap

Organization Active NPI

Pediatric Associates of the Northwest, PC

  • Pediatrics Physician
  • Beaverton, OR
National Provider Identifier
1093670606
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PEDIATRIC ASSOCIATES OF THE NORTHWEST, PC
Practice address
14795 SW Murray Scholls Dr Ste 121
Beaverton, OR 97007-9713
Phone
(503) 673-1071
Fax
(503) 227-0676
NPI assigned
Dec 17, 2025
Organization subpart
Yes
Parent organization
PEDIATRIC ASSOCIATES OF THE NORTHWEST, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

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

Authorized official

Name
Jill Ewanchuk
Title
Practice Administrator
Phone
(503) 227-0671

Specialties & licenses 1

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

Addresses

Primary practice location

14795 SW Murray Scholls Dr Ste 121
Beaverton, OR 97007-9713

Mailing address

14795 SW Murray Scholls Dr Ste 121
Beaverton, OR 97007-9713
Phone (503) 673-1071

National Provider Directory

National Provider Directory
Tax ID family
Pediatric Associates of the Northwest PC4 organizations share this tax ID, including this one
Part of
Pediatric Associates of the Northwest PC

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1765929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765929600000",
    "number": "1093670606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14795 SW MURRAY SCHOLLS DR STE 121",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970079713",
            "telephone_number": "503-673-1071",
            "fax_number": "503-227-0676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14795 SW MURRAY SCHOLLS DR STE 121",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970079713",
            "telephone_number": "503-673-1071",
            "fax_number": "503-227-0676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ASSOCIATES OF THE NORTHWEST, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PEDIATRIC ASSOCIATES OF THE NORTHWEST, PC",
        "enumeration_date": "2025-12-17",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A",
        "authorized_official_last_name": "EWANCHUK",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "503-227-0671"
    },
    "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 Dec 17, 2025; 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.