| NPI | 1891348447 |
|---|---|
| Doing Business As | PROVIDENCE EXPRESS CARE |
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Assistant Secretary For Enrollment 425-525-5392 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2019-07-23 |
| Last Update Date | 2021-03-03 |