| Providence Medical Group | |
|
315 Se Stone Mill Dr Suite 102 Vancouver WA 98684-6987 | |
| (360) 816-2700 | |
| (360) 816-2710 |
| Full Name | Providence Medical Group |
|---|---|
| Speciality | Radiology - Diagnostic Radiology |
| Location | 315 Se Stone Mill Dr, Vancouver, Washington |
| Authorized Official Name and Position | Donald Wayne Anderson (ASST SECRETARY FOR ENROLLMENTS/ EVP) |
| Authorized Official Contact | 4255255392 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Medical Group Po Box 3158 Portland OR 97208-3158 Ph: () - | Providence Medical Group 315 Se Stone Mill Dr Suite 102 Vancouver WA 98684-6987 Ph: (360) 816-2700 |
| NPI Number | 1326294117 |
|---|---|
| Provider Enumeration Date | 08/12/2008 |
| Last Update Date | 06/06/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326294117 | NPI | - | NPPES |
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