| NPI | 1447652797 |
|---|---|
| Doing Business As | PROVIDENCE INTEGRATIVE MEDICINE EAST |
| Doing Business As | PROVIDENCE MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Assistant Secretary Enrollment 425-525-5392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 202D00000X Integrative Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2014-09-18 |
| Last Update Date | 2025-06-30 |