| NPI | 1083059778 |
|---|---|
| Doing Business As | PROVIDENCE GYNECOLOGY CLINIC WEST |
| Entity Type | Organization |
| Authorized Contact | KEENAN B FREEMAN CFO 503-893-6524 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology |
| Enumeration Date | 2013-05-08 |
| Last Update Date | 2013-05-08 |