NPI | 1003223959 |
---|---|
Doing Business As | PROVIDENCE MEDICAL GROUP |
Doing Business As | PROVIDENCE MEDICAL GROUP NEWBERG SPECIALTIES AT TANASBOURNE |
Entity Type | Organization |
Authorized Contact | DONALD WAYNE ANDERSON Asst Secretary For Enrollment 425-358-9786 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine |
Additional Taxonomies | 261Q00000X Clinic/Center |
Enumeration Date | 2014-07-11 |
Last Update Date | 2025-06-20 |