| NPI | 1417191057 |
|---|---|
| Other Name | PROVIDENCE SMMC UROLOGY DME |
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Assistant Secretary Of Enrollments 425-358-9786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: WA HAC.FS.00000050) |
| Enumeration Date | 2009-04-27 |
| Last Update Date | 2025-05-07 |