| NPI | 1760636690 |
|---|---|
| Doing Business As | PROVIDENCE MEDICAL GROUP SOUTHEAST WASHINGTON NEUROSURGERY |
| Entity Type | Organization |
| Authorized Contact | DONALD W. ANDERSON Assistant Secretary Of Enrollments 425-358-9786 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WA H-050) |
| Enumeration Date | 2008-11-05 |
| Last Update Date | 2025-05-07 |