PROVIDENCE PHYSICIAN GROUP

MONROE, WA
NPI1548282189
Entity TypeOrganization
Authorized ContactBARBARA SCHUMACHER
Pro Fee Credentialing Manager
360-794-7994
Organization Subpart ?No
Primary Taxonomy207R00000X Internal Medicine
Additional Taxonomies332B00000X Durable Medical Equipment & Medical Supplies
Enumeration Date2006-07-24
Last Update Date2010-03-11
Business Address
PROVIDENCE PHYSICIAN GROUP
14692 179TH AVE SE SUITE 900
MONROE, WA 98272-1198
Phone number: 360-794-7994
Mailing Address
PROVIDENCE PHYSICIAN GROUP
909 N BROADWAY PBO/CREDENTIALING
EVERETT, WA 98201-1409
Phone number: 425-317-0246