Children'S Clinic of South Snohomish County, LTD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

CHILDREN'S CLINIC OF SOUTH SNOHOMISH COUNTY, LTD

Practice address

21600 Hwy 99
Suite 290
Edmonds, WA 98026-8012

Phone

(425) 778-0191

Fax

(425) 672-2110

NPI assigned

Apr 4, 2008

Organization subpart

No

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

Authorized official

Name

Lisa M Govaert

Title

Office Manager

Phone

(425) 775-7464

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1207267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207267200000",
    "number": "1669645172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21600 HWY 99",
            "address_2": "SUITE 290",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980268012",
            "telephone_number": "425-778-0191",
            "fax_number": "425-672-2110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21600 HWY 99",
            "address_2": "SUITE 290",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980268012",
            "telephone_number": "425-778-0191",
            "fax_number": "425-672-2110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S CLINIC OF SOUTH SNOHOMISH COUNTY, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-04",
        "last_updated": "2008-04-04",
        "status": "A",
        "authorized_official_last_name": "GOVAERT",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "425-775-7464"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7077027",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dongliang Chen
• Wen Chen
• Susan Annette Cherry, AAS, CDP
• Chesed Health Care PS
• Benjamin Chia, M.D.
• Amanda Rustine Chin, R.PH.
• Cyurry Choi, PHARMD
• NA Rae Choi, OTA
• Pamela J Chong, RN
• Anita Chopra, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 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.