NPI 1093929226

Westside Pediatric Clinic PC

Organisation Pediatrics Physician Portland, OR

Practice location

Address: 9555 SW Barnes Rd Suite 270, Portland, OR 97225
Phone: (503) 297-1025
Fax: (503) 297-1043

Authorised official

Name: Connie Lynn Distefano
Title: Administrator
Phone: (503) 297-1025

Registered specialties

Pediatrics Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208000000X

Other Pediatrics providers in Oregon →

Registry record

NPI: 1093929226
Entity type: Organization
NPI issued: 9 May 2007
Record last updated: 11 Apr 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.