| NPI | 1306174438 |
|---|---|
| Doing Business As | PROVIDENCE OCCUPATIONAL MEDICINE-TANASBOURNE/BRIDGEPORT |
| Entity Type | Organization |
| Authorized Contact | DONALD W ANDERSON Reimbursement Director Administrati 425-525-5392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QX0100X Clinic/Center Occupational Medicine |
| Enumeration Date | 2009-12-01 |
| Last Update Date | 2017-03-30 |