| NPI | 1790025104 |
|---|---|
| Doing Business As | PROVIDENCE HEART CLINIC EAST AT PPMC |
| Entity Type | Organization |
| Authorized Contact | KEENAN B FREEMAN CFO 503-893-6524 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease |
| Enumeration Date | 2013-02-21 |
| Last Update Date | 2013-02-21 |