NPI | 1033299458 |
---|---|
Doing Business As | PROVIDENCE PEDS SPEC MJP |
Entity Type | Organization |
Authorized Contact | DONALD W ANDERSON Assistant Secretary Of Enrollments 425-358-9786 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center |
Enumeration Date | 2006-10-17 |
Last Update Date | 2025-05-15 |