| NPI | 1689836108 |
|---|---|
| Doing Business As | PROVIDENCE MEDICAL GROUP |
| Doing Business As | PROVIDENCE SOUTHEAST ONCOLOGY & HEMATOLOGY CLINIC |
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Assistant Secreatry For Enrollment 425-358-9786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2025-06-30 |