| NPI | 1760633879 |
|---|---|
| Doing Business As | PROVIDENCE PHYSICIAN GROUP - EVERETT NEURO |
| Entity Type | Organization |
| Authorized Contact | DONALD W ANDERSON Assistant Secretary Of Enrollments 425-358-9786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2008-10-07 |
| Last Update Date | 2025-05-14 |