| NPI | 1306391446 |
|---|---|
| Doing Business As | PMG PHC PROVIDENCE EXPRESS CARE |
| Entity Type | Organization |
| Authorized Contact | DONALD ANDERSON Director Reimbursement Administrati 425-525-5392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2016-08-18 |
| Last Update Date | 2017-11-26 |