| NPI | 1629146121 |
|---|---|
| Doing Business As | PROVIDENCE MEDICAL GROUP |
| Doing Business As | PMG NEWBERG SURGICAL SERVICES |
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Assistant Secreatry For Enrollment 425-358-9786 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 207Y00000X Otolaryngology |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2025-07-04 |