| NPI | 1568547503 |
|---|---|
| Doing Business As | PROVIDENCE MEDICAL GROUP SOUTH |
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Assistant Secretary Enrollment 425-358-9786 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 207R00000X Internal Medicine | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
| 2084P0805X | |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2025-11-19 |