| NPI | 1689873937 |
|---|---|
| Other Name | PROVIDENCE CENTRALIA HOSPITAL - PEDIATRIC AFTER HOURS CLINIC |
| Entity Type | Organization |
| Authorized Contact | NICOLE QUINN Payor Credentialing Manager 425-525-6715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X (Licence: WA 000057) |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2010-12-22 |