Unknown Individual – Pediatric Adolescent Medicine Physician, NPI 1538140033
Pediatric Adolescent Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
505, Northeast 87th Avenue, McLoughlin Heights, Vancouver, Clark County, Washington, 98664, United States
STE 120
VANCOUVER, WA 986641989
Phone: (360) 892-1635
Fax: (360) 892-3146
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 98664)
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