NPI | 1346520327 |
---|---|
Doing Business As | PROVIDENCE MEDICAL GROUP |
Doing Business As | PROVIDENCE BREAST CARE CLINIC - WEST |
Entity Type | Organization |
Authorized Contact | DONALD WAYNE ANDERSON Assistant Secretary Enrollment 425-358-9786 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center |
Additional Taxonomies | 207RX0202X Internal Medicine, Medical Oncology |
Enumeration Date | 2011-08-23 |
Last Update Date | 2025-06-30 |