# PROVIDENCE PHYSICIAN SERVICES CO

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PROVIDENCE PHYSICIAN SERVICES CO
- **Other names:** PPS PROV FAMILY MED NORTHPOINT
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1982921649
- **Legal business name:** PROVIDENCE PHYSICIAN SERVICES CO
- **Authorized official:** ANSELMO NUNEZ (CFO)
- **Authorized official phone:** (509) 474-6616

## Contact information

- **Practice address:** 212 E CENTRAL, STE 440, SPOKANE, WA 99208-6290
- **Practice address phone:** (509) 252-9602
- **Mailing address:** 101 W 8TH AVE, MOTHER GAMELIN CENTER, 3RD FLOOR, SPOKANE, WA 99204-2307

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/21/2010
- **Last updated:** 02/28/2011