| NPI | 1326294117 |
|---|---|
| Doing Business As | PROVIDENCE MEDICAL GROUP |
| Doing Business As | PROVIDENCE MEDICAL GROUP MILL PLAIN |
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Assistant Secretary Enrollment 425-358-9786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 207RG0300X Internal Medicine, Geriatric Medicine | |
| 225100000X Physical Therapist | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2008-08-12 |
| Last Update Date | 2025-07-04 |