| NPI | 1578807418 |
|---|---|
| Doing Business As | PROVIDENCE MEDICAL GROUP |
| Doing Business As | PROVIDENCE NEUROLOGICAL SPECIALTIES EAST |
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Assistant Secretary Enrollments 425-525-5392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2024-10-01 |