NPIMap

Organization Active NPI

Pediatric Associates of the Northwest, PC

  • Pediatrics Physician
  • Beaverton, OR
National Provider Identifier
1528066859
Registry record updated Oct 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2000742 Issued in OR
Legal business name
PEDIATRIC ASSOCIATES OF THE NORTHWEST, PC
Practice address
14795 SW Murray Schools Dr.
Suite 121
Beaverton, OR 97007
Phone
(503) 673-1071
Fax
(503) 227-4589
NPI assigned
Jul 11, 2005
Last updated
Oct 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2020

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

Authorized official

Name
Pamela Colburn
Title
Practice Administrator
Phone
(503) 419-4940

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X 2000742 OR Primary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X 646412 OR

Addresses

Primary practice location

14795 SW Murray Schools Dr.
Suite 121
Beaverton, OR 97007

Mailing address

2701 NW Vaughn St
Suite 360
Portland, OR 97210
Phone (503) 227-0671

National Provider Directory

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

Other organizations with this tax ID 3

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

Locations

2525 NW Lovejoy St
Ste 200
Portland, OR 97210
Phone (503) 227-0671

2701 NW Vaughn St
Ste 360
Portland, OR 97210
Phone (503) 227-0671

Ownership & related parties

Subparts reporting this organization as parent 3

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 33

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603324800000",
    "number": "1528066859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 NW VAUGHN ST",
            "address_2": "SUITE 360",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97210",
            "telephone_number": "503-227-0671",
            "fax_number": "503-227-0676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14795 SW MURRAY SCHOOLS DR.",
            "address_2": "SUITE 121",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "97007",
            "telephone_number": "503-673-1071",
            "fax_number": "503-227-4589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ASSOCIATES OF THE NORTHWEST, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-11",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A",
        "authorized_official_last_name": "COLBURN",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "503-419-4940"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "2000742",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "646412",
            "primary": false
        }
    ],
    "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 Oct 22, 2020; 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.