| NPI | 1134355985 |
|---|---|
| Doing Business As | PROVIDENCE INTEGRATIVE MEDICINE EAST |
| Entity Type | Organization |
| Authorized Contact | WILLIAM OLSON Chief Financial Officer 503-215-7384 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2009-06-08 |
| Last Update Date | 2009-06-08 |