| NPI | 1366145716 |
|---|---|
| Doing Business As | PROVIDENCE MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Ass. Secretary Enrollment 425-525-5392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 202D00000X Integrative Medicine |
| 207N00000X Dermatology | |
| 207R00000X Internal Medicine | |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism | |
| 207RI0200X Internal Medicine, Infectious Disease | |
| 207RX0202X Internal Medicine, Medical Oncology | |
| 207X00000X Orthopaedic Surgery | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine | |
| 2083X0100X Preventive Medicine, Occupational Medicine | |
| 2085R0202X Radiology, Diagnostic Radiology | |
| 208600000X Surgery | |
| 208M00000X Hospitalist | |
| 261QE0002X Clinic/Center, Emergency Care | |
| 261QU0200X Clinic/Center, Urgent Care | |
| Enumeration Date | 2023-03-24 |
| Last Update Date | 2024-05-14 |