NPI | 1538546395 |
---|---|
Doing Business As | PROVIDENCE MEDICAL GROUP ESTHER SHORT |
Entity Type | Organization |
Authorized Contact | DONALD W ANDERSON Assistant Secretary Enrollment 425-358-9786 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine |
Additional Taxonomies | 207Q00000X Family Medicine |
261Q00000X Clinic/Center | |
Enumeration Date | 2015-04-30 |
Last Update Date | 2025-06-30 |