Northwest Pediatric Gastroenterology, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

NORTHWEST PEDIATRIC GASTROENTEROLOGY, LLC

Practice address

300 N Graham St
Suite 420
Portland, OR 97227-1683

Phone

(503) 281-5139

Fax

(503) 249-3782

NPI assigned

Jun 28, 2007

Last updated

Jul 14, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Debra P Schulz

Title

Clinic Manager

Phone

(503) 281-5139

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215993600000",
    "number": "1548467129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 N GRAHAM ST",
            "address_2": "SUITE 420",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271683",
            "telephone_number": "503-281-5139",
            "fax_number": "503-249-3782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N GRAHAM ST",
            "address_2": "SUITE 420",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271683",
            "telephone_number": "503-281-5139",
            "fax_number": "503-249-3782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST PEDIATRIC GASTROENTEROLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-28",
        "last_updated": "2008-07-14",
        "status": "A",
        "authorized_official_last_name": "SCHULZ",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "503-281-5139"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OREGON",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "WASHINGTON",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Northwest Neuro-Ophthalmology LLC
• Northwest Neurological Specialists PC
• Northwest Newborn Specialists PC
• Northwest Optometric Associates Inc (ABC Vision Source Hillsdale)
• Northwest Pediatric Critical Care PC
• Northwest Pediatric Kidney Specialists LLC
• Northwest Periodontics and Dental Implants LLC
• Northwest Permanente
• Northwest Permanente, P.C.
• Northwest Physical Therapy Care, LLC

• Specialist in Portland, OR
• Providers in Portland, OR by specialty
• Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2008; 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.