| NPI | 1861513731 |
|---|---|
| Doing Business As | PMG BETHANY |
| Doing Business As | PROVIDENCE MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | DONALD W ANDERSON Asst Sec Enroll 425-525-5392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207P00000X Emergency Medicine |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2024-06-13 |