| Providence Physician Group | |
|
12800 Bothell Everett Hwy Suite 160 Everett WA 98208-6644 | |
| (425) 316-5490 | |
| (425) 225-1002 |
| Full Name | Providence Physician Group |
|---|---|
| Speciality | Internal Medicine - Cardiovascular Disease |
| Location | 12800 Bothell Everett Hwy, Everett, Washington |
| Authorized Official Name and Position | Donald Wayne Anderson (ASST SEC FOR ENROLLMENT/DIR REIMB) |
| Authorized Official Contact | 4255255392 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Physician Group Po Box 34439 Seattle WA 98124-1439 Ph: (425) 316-5439 | Providence Physician Group 12800 Bothell Everett Hwy Suite 160 Everett WA 98208-6644 Ph: (425) 316-5490 |
| NPI Number | 1508000449 |
|---|---|
| Provider Enumeration Date | 04/22/2009 |
| Last Update Date | 04/01/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508000449 | NPI | - | NPPES |
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