| NPI | 1124270715 |
|---|---|
| Doing Business As | PMG NW WA |
| Doing Business As | PROVIDENCE MEDICAL GROUP NORTHWEST WASHINGTON |
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Assistant Secretary For Enrollment 425-525-5392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 225100000X Physical Therapist | |
| Enumeration Date | 2008-10-15 |
| Last Update Date | 2023-08-15 |