NPI | 1710307715 |
---|---|
Doing Business As | PROVIDENCE HEALTH EXPRESS AT GATEWAY |
Entity Type | Organization |
Authorized Contact | DONALD WAYNE ANDERSON Assistant Secretary Enrollment 425-358-9786 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center |
Enumeration Date | 2014-04-17 |
Last Update Date | 2025-07-04 |