| NPI | 1326569682 |
|---|---|
| Other Name | PROVIDENCE MEDICAL GROUP SOUTHEAST WASHINGTON |
| Entity Type | Organization |
| Authorized Contact | DONALD ANDERSON Asst Corp Secretary For Enrollments 425-525-5392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207X00000X Orthopaedic Surgery | |
| 208600000X Surgery | |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2017-06-27 |