| NPI | 1154672947 |
|---|---|
| Doing Business As | PROVIDENCE MEDICAL GROUP SOUTHEAST WASHINGTON RURAL HEALTH CLINIC |
| Entity Type | Organization |
| Authorized Contact | MICHAEL PARENTEAU Chief Financial Officer 509-522-5890 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2012-09-20 |
| Last Update Date | 2012-09-20 |