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General NPI Number Information
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NPI Number | 1518034180
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Entity Type | Organization
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Legal Business Name | N W PEDIATRIC CENTER INC P S
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 1911 COOKS HILL RD
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City | CENTRALIA
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State | WA
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Zip | 98531-9073
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Country | US
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Telephone | 360-736-6778
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Fax | 360-736-6552
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Provider Business Mailing Address
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Address Line | 1911 COOKS HILL RD
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City | CENTRALIA
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State | WA
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Zip | 98531-9073
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Country | US
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Telephone | 360-736-6778
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Fax | 360-736-6552
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | LISA GAIL MCKAY
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Credential |
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Telephone | 360-736-6778
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | AP30007039
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD00028578
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | AP60086265
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD00027525
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License Number State | WA
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Taxonomy #5
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD00038226
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License Number State | WA
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Taxonomy #6
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | MD00039351
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License Number State | WA
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Taxonomy #7
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD00032554
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License Number State | WA
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Taxonomy #8
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD00043677
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License Number State | WA
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Taxonomy #9
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | AP30006273
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License Number State | WA
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Taxonomy #10
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD00029916
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License Number State | WA
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