| NPI | 1891046926 |
|---|---|
| Doing Business As | PROVIDENCE MEDICAL GROUP SOUTHEAST WASHINGTON RURAL HEALTH CLINIC |
| Entity Type | Organization |
| Authorized Contact | MICHAEL PARENTEAU Chief Financial Officier 509-522-5890 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2012-09-28 |
| Last Update Date | 2012-09-28 |