| NPI | 1306097126 |
|---|---|
| Doing Business As | PROVIDENCE MEDICAL GROUP SOUTHEAST WASHINGTON IMAGING |
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Assistant Secretary Of Enrollments 425-525-5392 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology |
| Enumeration Date | 2008-10-10 |
| Last Update Date | 2024-11-11 |