NPI | 1811211220 |
---|---|
Doing Business As | PROVIDENCE MEDICAL GROUP |
Doing Business As | PROVIDENCE LIVER CANCER WEST |
Entity Type | Organization |
Authorized Contact | DONALD WAYNE ANDERSON Assistant Secretary Enrollments 425-358-9786 |
Organization Subpart ? | No |
Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology |
Additional Taxonomies | 261Q00000X Clinic/Center |
363L00000X Nurse Practitioner | |
Enumeration Date | 2010-03-15 |
Last Update Date | 2025-07-04 |