| NPI | 1679826317 |
|---|---|
| Doing Business As | PROVIDENCE THORACIC SURGERY WEST |
| Entity Type | Organization |
| Authorized Contact | KEENAN FREEMAN CFO 503-893-6524 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| Enumeration Date | 2012-10-18 |
| Last Update Date | 2014-12-30 |