NPI | 1790880805 |
---|---|
Doing Business As | PROVIDENCE MEDICAL GROUP CASCADE |
Entity Type | Organization |
Authorized Contact | DONALD WAYNE ANDERSON Asst Sec For Enrollment/Dir Reimb S 425-525-5392 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center |
Enumeration Date | 2006-09-13 |
Last Update Date | 2021-04-16 |