| NPI | 1699804336 |
|---|---|
| Doing Business As | PROVIDENCE NEUROLOGICAL SPECIALTIES PSV MJP |
| Doing Business As | PROVIDENCE MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Assistandt Secretary Enrollment 425-525-5392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2024-09-29 |