| NPI | 1154539203 | 
|---|---|
| Doing Business As | PROVIDENCE MEDICAL GROUP | 
| Other Name | PMG/OREGON CITY | 
| Entity Type | Organization | 
| Authorized Contact | DONALD WAYNE ANDERSON Asst Sec Enrollment 425-358-9786  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine | 
| Enumeration Date | 2007-05-21 | 
| Last Update Date | 2025-06-20 |