| NPI | 1841756764 |
|---|---|
| Doing Business As | PROVIDENCE SEASIDE HOSPITAL, PROVIDENCE CANNON BEACH CLINIC |
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Asst Corp Secretary For Enrollments 425-525-5392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2019-02-15 |
| Last Update Date | 2020-02-06 |