| NPI | 1689845489 |
|---|---|
| Doing Business As | PROVIDENCE MEDICALGROUP |
| Doing Business As | PROV PEDS NEUROLOGY SALEM |
| Entity Type | Organization |
| Authorized Contact | DONALD W ANDERSON Assistant Secretary Enrollment 425-358-9786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2008-03-19 |
| Last Update Date | 2025-07-04 |