NPI | 1902083017 |
---|---|
Doing Business As | PROVIDENCE MEDICAL GROUP |
Doing Business As | PEDIATRIC NEUROLOGY |
Entity Type | Organization |
Authorized Contact | DONALD WAYNE ANDERSON Assistant Secretary Enrollment 425-358-9786 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine |
Additional Taxonomies | 261Q00000X Clinic/Center |
Enumeration Date | 2008-01-31 |
Last Update Date | 2025-07-04 |