| NPI | 1275785669 |
|---|---|
| Doing Business As | PROVIDENCE PHYSICIAN GROUP DEXASCAN PHCC |
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Assistant Secretary Of Enrollments 425-358-9786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2471B0102X Radiologic Technologist, Bone Densitometry |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2008-10-16 |
| Last Update Date | 2025-07-31 |