| NPI | 1255740965 |
|---|---|
| Doing Business As | PROVIDENCE MEDICAL GROUP |
| Doing Business As | PROVIDENCE GENETIC RISK ASSESSMENT WEST |
| Entity Type | Organization |
| Authorized Contact | DONALD W ANDERSON Assistant Secretary Enrollment 425-525-5392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2014-08-06 |
| Last Update Date | 2024-09-29 |