| NPI | 1760636690 |
|---|---|
| Doing Business As | PROVIDENCE MEDICAL GROUP SOUTHEAST WASHINGTON NEUROSURGERY |
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Assistant Secretary Of Enrollment 425-525-5392 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WA H-050) |
| Enumeration Date | 2008-11-05 |
| Last Update Date | 2024-08-05 |