# PROVIDENCE HEALTH & SERVICES MT

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PROVIDENCE HEALTH & SERVICES
- **Other names:** PMG MT IHI SEELEY SWAN
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1679865497
- **Legal business name:** PROVIDENCE HEALTH & SERVICES
- **Authorized official:** TERRI MASTERS (RCM OPERATIONS MANAGER)
- **Authorized official phone:** (406) 329-5795

## Contact information

- **Practice address:** 3050 HIGHWAY 83 N, SEELEY LAKE, MT 59868
- **Practice address phone:** (866) 366-2983
- **Mailing address:** PO BOX 12, LIBERTY LAKE, WA 99019-0012
- **Mailing address phone:** (406) 327-1918

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | — | NULL | Yes |
| 363A00000X | Physician Assistant | — | — | Yes |

## Other

- **Enumeration date:** 05/12/2011
- **Last updated:** 02/12/2014