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Organization

PROVIDENCE HEALTH & SERVICES MT

Active
Parent organization
PROVIDENCE HEALTH & SERVICES
Other names
PMG MT Women's Care Center
Organization subpart
Yes

Provider details

NPI number
Legal business name
PROVIDENCE HEALTH & SERVICES
Authorized official
DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY ENROLLMENTS)
(425) 358-9786
Entity
Organization

Contact information

Practice address
500 W BROADWAY ST, 3RD FLOOR, MISSOULA, MT 59802-4096
(406) 327-3057
(406) 327-3231
Mailing address
PO BOX 31001-4114, PASADENA, CA 91110-4114
(406) 327-1918
(406) 329-2937

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary

Other

Enumeration date
03/06/2009
Last updated
06/20/2025
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