| NPI | 1609204312 |
|---|---|
| Doing Business As | PROVIDENCE HEALTH EXPRESS HV |
| Entity Type | Organization |
| Authorized Contact | KEENAN B FREEMAN CFO 503-593-6524 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2013-10-16 |
| Last Update Date | 2013-10-16 |