Siskiyou Pediatric Clinic, LLP
NPI #1700999521 in Grants Pass, Oregon
Provider Information
- NPI Number
- 1700999521
- Entity Type
- Organization
- Organization Name
- Siskiyou Pediatric Clinic, LLP
- Primary Specialty
- Pediatrics
- Enumeration Date
- Aug 16, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 700 RAMSEY AVE STE 204
- City
- Grants Pass
- State
- Oregon
- ZIP Code
- 97527-5792
- Phone
- (541) 955-5683
Authorized Official
- Name
- CHARLES RAY CRISPEN JR., D.O.
- Title
- OWNER/PHYSICIAN
- Phone
- (541) 955-5683
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pediatrics |
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