| NPI | 1093963209 |
|---|---|
| Doing Business As | PROVIDENCE MEDICAL GROUP |
| Doing Business As | PROVIDENCE PSYCHIATRY EAST |
| Entity Type | Organization |
| Authorized Contact | DONALD W ANDERSON Assistant Secretary Of Enrollments 425-358-9786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
| 2084P0805X | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2008-08-29 |
| Last Update Date | 2025-06-20 |