| NPI | 1700166782 |
|---|---|
| Doing Business As | PROVIDENCE MEDICAL GROUP |
| Doing Business As | PROVIDENCE BREAST CARE CLINIC - EAST |
| Entity Type | Organization |
| Authorized Contact | DONALD W ANDERSON Assistant Secretary Enrollments 425-358-9786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2011-08-23 |
| Last Update Date | 2025-06-30 |