| NPI | 1861623548 |
|---|---|
| Doing Business As | PROVIDENCE FAMILY MEDICINE WEST OLYMPIA |
| Entity Type | Organization |
| Authorized Contact | NICOLE QUINN Payor Credentialing Manager 425-525-6715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Enumeration Date | 2009-07-29 |
| Last Update Date | 2011-04-06 |