| NPI | 1659451086 |
|---|---|
| Doing Business As | PROVIDENCE PEDIATRIC SPECIALTIES III |
| Entity Type | Organization |
| Authorized Contact | MITCHELL NEYHART CFO 503-574-9840 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2010-04-20 |