Provider Demographics
NPI:1437296910
Name:COLUMBIA PEDIATRICS P.S.
Entity Type:Organization
Organization Name:COLUMBIA PEDIATRICS P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:S
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-663-8767
Mailing Address - Street 1:933 RED APPLE RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-3370
Mailing Address - Country:US
Mailing Address - Phone:509-663-8767
Mailing Address - Fax:509-663-1421
Practice Address - Street 1:933 RED APPLE RD
Practice Address - Street 2:SUITE C
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-3370
Practice Address - Country:US
Practice Address - Phone:509-663-8767
Practice Address - Fax:509-663-1421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Single Specialty