| NPI | 1295105518 |
|---|---|
| Doing Business As | PROVIDENCE MEDICAL GROUP |
| Doing Business As | PROVIDENCE CHILDREN'S DEVELOPMENT INSTITUTE AT CHILD CENTER |
| Entity Type | Organization |
| Authorized Contact | DONALD W ANDERSON Assistant Secretary Enrollment 425-358-9786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| Additional Taxonomies | 2080P0008X Pediatrics, Neurodevelopmental Disabilities |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2015-09-29 |
| Last Update Date | 2025-06-20 |