| NPI | 1194930313 |
|---|---|
| Doing Business As | PROVIDENCE ST PETER INTERNAL MEDI |
| Entity Type | Organization |
| Authorized Contact | NICOLE QUINN Payor Credentialing Manager 425-525-6715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2010-12-22 |