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Peninsula Childrens Clinic INC

Clinic/Center in Port Angeles, WA. Organization (NPI-2).

NPI number1528025293
StatusActive
Last updated in NPPESNov 5, 2015

Details

NPI
1528025293
Entity type
Organization (NPI-2)
Legal business name
Peninsula Childrens Clinic INC
Organization subpart
No
Enumeration date
Apr 27, 2006
Last updated
Nov 5, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center601481297WAYes

Practice location

902 E Caroline
Port Angeles, WA 98362

Phone 360-457-8578 · Fax 360-457-4841

Mailing address

902 E Caroline
Port Angeles, WA 98362

Phone 360-457-8578 · Fax 360-457-4841

Authorized official

Jeffrey Charles Weller
Pediatrician
3604578578

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