Provider Demographics
NPI:1659965333
Name:KEBLAWI PEDIATRICS, PLLC
Entity Type:Organization
Organization Name:KEBLAWI PEDIATRICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMIR
Authorized Official - Middle Name:SAID
Authorized Official - Last Name:KEBLAWI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-869-4929
Mailing Address - Street 1:15405 N ADDISON CT
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-8716
Mailing Address - Country:US
Mailing Address - Phone:509-869-4929
Mailing Address - Fax:
Practice Address - Street 1:731 N STANLEY ST
Practice Address - Street 2:
Practice Address - City:MEDICAL LAKE
Practice Address - State:WA
Practice Address - Zip Code:99022-8940
Practice Address - Country:US
Practice Address - Phone:509-869-4929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-24
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty