| Providence Medical Group Southwest Washington | |
|
1018 Capitol Way S Ste 300 Olympia WA 98501-1212 | |
| (360) 486-6508 | |
| (360) 570-2077 |
| Full Name | Providence Medical Group Southwest Washington |
|---|---|
| Speciality | General Practice |
| Location | 1018 Capitol Way S Ste 300, Olympia, Washington |
| Authorized Official Name and Position | Donald W 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 Medical Group Southwest Washington Po Box 3360 Portland OR 97208-3360 Ph: (360) 486-6508 | Providence Medical Group Southwest Washington 1018 Capitol Way S Ste 300 Olympia WA 98501-1212 Ph: (360) 486-6508 |
| NPI Number | 1134656135 |
|---|---|
| Provider Enumeration Date | 05/22/2017 |
| Last Update Date | 11/26/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134656135 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
News Archive
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