Snake River Pediatrics, PC
Snake River Pediatrics, PC is a Pediatrics Physician in Fruitland, Idaho. Licensed in Oregon. Registered with an NPI since 2015.
- Licensed in
- OR
- In the registry since
- 2015
- Specialties on file
- 2
What do these letters mean?
- PC — Professional corporation
- A form of business registration, not a clinical qualification.
Practice location Address checks out
1100 NW 12th StFruitland, ID 83619-5040
Phone: (208) 452-6556
Fax: (541) 216-6557
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Rural Health Clinic/Center (primary) | Taxonomy 261QR1300X · Licence PA000913 (OR) |
|---|---|
| Pediatrics Physician | Taxonomy 208000000X · Licence PA000913 (OR) |
Record details
| NPI number | 1700269792 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Matthew Berria — President · (208) 740-4518 |
| NPI enumerated | July 8, 2015 |
| Last updated in NPPES | August 16, 2023 |
| Certification date | August 16, 2023 |
| Mailing address | 1100 Nw 12th St, Fruitland, ID 83619-5040 |
Other providers in Fruitland
-
Abby Lynn Davis
1100 NW 12th St, Fruitland, ID 83619-5040 · (208) 452-6556
-
Michelle F Devoe, DO
1100 NW 12th St, Fruitland, ID 83619-5040 · (208) 452-6556
-
Snake River Pediatrics, PC
1100 NW 12th St, Fruitland, ID 83619-5040 · (208) 452-6556