| NPI | 1568793313 |
|---|---|
| Doing Business As | PROVIDENCE MEDICAL GROUP WEST LINN |
| Doing Business As | PROVIDENCE MEDICAL GROUP |
| Doing Business As | PROVIDENCE MEDICAL GROUP AT MARYS WOODS |
| Entity Type | Organization |
| Authorized Contact | DONALD W ANDERSON Assistant Secretary Enrollment 425-525-5392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2010-01-19 |
| Last Update Date | 2024-09-04 |