| NPI | 1306097126 |
|---|---|
| Doing Business As | PROVIDENCE MEDICAL GROUP SOUTHEAST WASHINGTON IMAGING |
| Entity Type | Organization |
| Authorized Contact | MICHAEL PARENTEAU Chief Financial Officer 509-522-5890 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology |
| Enumeration Date | 2008-10-10 |
| Last Update Date | 2012-09-25 |