| NPI | 1346619467 |
|---|---|
| Doing Business As | PROVIDENCE MEDICAL GROUP SOUTH |
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Assistant Secretary Enrollment 425-358-9786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
| 2084P0805X | |
| 207X00000X Orthopaedic Surgery | |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2015-09-18 |
| Last Update Date | 2025-11-19 |