| NPI | 1548571615 |
|---|---|
| Other Name | PROVIDENCE FAMILY MEDICINE EAST OLYMPIA |
| Entity Type | Organization |
| Authorized Contact | DANIEL T HARRIS CFO 425-687-3603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2011-02-01 |