Organization
PROVIDENCE HEALTH & SERVICES MT
Active
Other names
Providence Medical Group Montana
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY ENROLLMENT)
(425) 358-9786
Entity
Organization
Contact information
Practice address
3017 PAXSON STREET, MISSOULA, MT 59801
(406) 519-3422
Mailing address
PO BOX 31001 - 4114, PASADENA, CA 91110-4114
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
12/11/2025
Last updated
12/11/2025
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