| NPI | 1083963573 |
|---|---|
| Doing Business As | PROVIDENCE THE DALLES ENT |
| Entity Type | Organization |
| Authorized Contact | DONALD W ANDERSON Dir Reimb Reg Strat/Asst Sec Enroll 425-525-5392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 207Y00000X Otolaryngology |
| Enumeration Date | 2012-08-30 |
| Last Update Date | 2021-01-15 |