| NPI | 1912207853 |
|---|---|
| Doing Business As | PROVIDENCE UROLOGY - OLYMPIA |
| Entity Type | Organization |
| Authorized Contact | NICHOLE QUINN Manager Profee Payor Credentialing 425-525-6715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Enumeration Date | 2010-10-26 |
| Last Update Date | 2011-04-06 |