PROVIDENCE PHYSICIAN GROUP

EVERETT, WA
NPI1871515429
Entity TypeOrganization
Authorized ContactBARBARA SCHUMACHER
Pro Fee Credentialing Manager
425-261-4925
Organization Subpart ?No
Primary Taxonomy207R00000X Internal Medicine
Additional Taxonomies332B00000X Durable Medical Equipment & Medical Supplies
363LG0600X Nurse Practitioner, Gerontology
2471B0102X Radiologic Technologist, Bone Densitometry
Enumeration Date2006-07-24
Last Update Date2010-03-11
Business Address
PROVIDENCE PHYSICIAN GROUP
1330 ROCKEFELLER AVE SUITE 230
EVERETT, WA 98201-1684
Phone number: 425-261-4925
Mailing Address
PROVIDENCE PHYSICIAN GROUP
909 N BROADWAY PBO/CREDENTIALING
EVERETT, WA 98201-1409
Phone number: 425-317-0246