Pediatric Clinic, Inc., P.S.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

600024847 Issued in WA

Legal business name

PEDIATRIC CLINIC, INC., P.S.

Practice address

784 14TH Ave
Longview, WA 98632-2315

Phone

(360) 425-6117

Fax

(360) 636-1297

NPI assigned

Aug 25, 2006

Organization subpart

No

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

Authorized official

Name

Cindy A Strandberg

Title

Office Administrator

Phone

(360) 425-6117

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Karen Sachiko Kato, M.D.

  • Pediatric Adolescent Medicine Physician
  • Longview, WA
  • NPI 1598756967
  NPD (past)

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294876800000",
    "number": "1639287188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "784 14TH AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322315",
            "telephone_number": "360-425-6117",
            "fax_number": "360-425-8557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "784 14TH AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322315",
            "telephone_number": "360-425-6117",
            "fax_number": "360-636-1297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC CLINIC, INC., P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-25",
        "last_updated": "2011-01-13",
        "status": "A",
        "authorized_official_last_name": "STRANDBERG",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "360-425-6117"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WA",
            "license": "600024847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7851702",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peacehealth St John Medical Center
• Tia Pearrow
• Diana Carole Pearson, BA
• Michael Pearson, AAC
• Pediatric Cardiology Center of Oregon PC
• Kortnie Victoria Pena
• Angela Diane Pence, MSW, LICSW, DMHP
• Austyn Pence
• Gary Elliot Penner, MD
• Gareth John Penta, DNP, ARNP, PMHNP-BC

• Clinic/Center in Longview, WA
• Providers in Longview, WA by specialty
• Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2011; 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.