Southwest Pediatrics

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

SOUTHWEST PEDIATRICS

Practice address

14212 Ambaum Blvd SW
Southwest Pediatrics #202
Seattle, WA 98166-1437

Phone

(206) 243-4811

Fax

(206) 243-2822

NPI assigned

May 24, 2007

Last updated

Aug 22, 2020By 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

Mr. Kenneth H Dong, MDNPI 1306911425

Title

Vice President

Phone

(206) 243-4811

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

Locations

Practitioners 3

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.

• Kenneth Hee Yong Dong, MD

  • Pediatrics Physician
  • Seattle, WA
  • NPI 1306911425
  NPD (past) Authorized official
• Paymon Elahi, MD

  • Pediatrics Physician
  • Seattle, WA
  • NPI 1407921521
  NPD (past)
• Theresa L Hineline, MD

  • Pediatrics Physician
  • Seattle, WA
  • NPI 1336214451
  NPD (past)

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659582385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14212 AMBAUM BLVD SW",
            "address_2": "#202",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981661437",
            "telephone_number": "206-243-4811",
            "fax_number": "206-243-2822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14212 AMBAUM BLVD SW",
            "address_2": "SOUTHWEST PEDIATRICS #202",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981661437",
            "telephone_number": "206-243-4811",
            "fax_number": "206-243-2822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DONG",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "206-243-4811",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Sound Laser Services LLC
• Allen Gregg South, M.D.
• Southeast Youth and Family Services
• Southgate Medical Clinic, P.S.
• Southgate Medical Clinic, P.S.
• Southwest Youth and Family Services
• Siri Southwick-Young, LMP
• Jensen Southwick
• Catherine Elizabeth Southworth, MS, RD, LMHC-A
• Kelly Souza, MSOT, OTR/L

• Pediatrics Physician in Seattle, WA
• Providers in Seattle, WA by specialty
• Pediatrics Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.