| NPI | 1033309604 |
|---|---|
| Doing Business As | PROVIDENCE ST PETER INTERNAL MEDI |
| Entity Type | Organization |
| Authorized Contact | NICOLE QUINN Payor Credentialing Manager 425-525-6715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine Geriatric Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism | |
| 207RG0300X Internal Medicine Geriatric Medicine | |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2010-12-22 |