| NPI | 1093135535 |
|---|---|
| Doing Business As | PROVIDENCE MEDICAL GROUP SCHOLLS PEDIATRICS |
| Entity Type | Organization |
| Authorized Contact | DONALD W ANDERSON Dir Reimb Reg Strat/Asst Sec Enroll 425-525-5392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2014-04-23 |
| Last Update Date | 2021-01-13 |