| NPI | 1710161344 |
|---|---|
| Doing Business As | PROVIDENCE ST PETER INTERNAL MEDI |
| Entity Type | Organization |
| Authorized Contact | NICOLE QUINN Payor Credentialing Manager 425-525-6715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Enumeration Date | 2007-12-18 |
| Last Update Date | 2010-12-22 |