Provider Demographics
NPI:1083815666
Name:NORTHWEST CLOINIC FOR CHILDREN
Entity Type:Organization
Organization Name:NORTHWEST CLOINIC FOR CHILDREN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERI
Authorized Official - Middle Name:
Authorized Official - Last Name:CAIAFA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-866-1974
Mailing Address - Street 1:15420 N 32ND DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85053-3927
Mailing Address - Country:US
Mailing Address - Phone:602-866-1974
Mailing Address - Fax:602-789-9202
Practice Address - Street 1:15420 N 32ND DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85053-3927
Practice Address - Country:US
Practice Address - Phone:602-866-1974
Practice Address - Fax:602-789-9202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty