NPI | 1164522496 |
---|---|
Doing Business As | PROVIDENCE MEDICAL GROUP |
Doing Business As | PROVIDENCE MEDICAL GROUP NORTH PORTLAND FAMILY & COMMUNITY MEDICINE |
Entity Type | Organization |
Authorized Contact | DONALD WAYNE ANDERSON Assistant Secretary Enrollments 425-525-5392 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 261Q00000X Clinic/Center |
Enumeration Date | 2006-09-25 |
Last Update Date | 2024-10-22 |