| NPI | 1508000449 |
|---|---|
| Doing Business As | PMG NW WA CARDIOLOGY |
| Doing Business As | PROVIDENCE PHYSICIAN GROUP |
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Asst Sec For Enrollment/Dir Reimb 425-525-5392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2009-04-22 |
| Last Update Date | 2021-04-01 |