| NPI | 1194189654 |
|---|---|
| Doing Business As | PROVIDENCE FAMILY PRACTICE |
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Assistant Secretary Of Enrollments 425-358-9786 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2025-05-07 |