| NPI | 1013192806 |
|---|---|
| Doing Business As | PROVIDENCE MEDICAL GROUP |
| Doing Business As | PROVIDENCE PSYCHIATRY WEST |
| Entity Type | Organization |
| Authorized Contact | DONALD W ANDERSON Assistant Secretary Enrollment 425-525-5392 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 363L00000X Nurse Practitioner | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2007-12-31 |
| Last Update Date | 2024-06-13 |