| NPI | 1114085545 |
|---|---|
| Doing Business As | PMG NEWBERG SPECIALTY MEDICINE |
| Doing Business As | PROVIDENCE MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Assistant Secretary Enrollment 425-358-9786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease |
| 207T00000X Neurological Surgery | |
| 207Y00000X Otolaryngology | |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2025-06-20 |