Provider Demographics
NPI:1467514737
Name:DEVOE PEDIATRICS PC
Entity Type:Organization
Organization Name:DEVOE PEDIATRICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, SHAREHOLDER S CORP
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:FRANCES
Authorized Official - Last Name:DEVOE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:541-889-0878
Mailing Address - Street 1:2625 PATRICIA AVE
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:OR
Mailing Address - Zip Code:97914-5308
Mailing Address - Country:US
Mailing Address - Phone:541-889-5280
Mailing Address - Fax:
Practice Address - Street 1:49 NW 1ST ST
Practice Address - Street 2:STE 6
Practice Address - City:ONTARIO
Practice Address - State:OR
Practice Address - Zip Code:97914-2468
Practice Address - Country:US
Practice Address - Phone:541-889-0878
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Not Answered2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Multi-Specialty
Not Answered2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral PediatricsGroup - Multi-Specialty