| NPI | 1285927988 |
|---|---|
| Doing Business As | PROVIDENCE MEDICAL GROUP |
| Doing Business As | PROVIDENCE VALVE CENTER |
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Asst Sec For Enrollment 425-525-5392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2011-05-27 |
| Last Update Date | 2024-09-29 |