Organization
PROVIDENCE HEALTH & SERVICES MT
Active
Parent organization
PROVIDENCE HEALTH & SERVICES
Other names
PMG MT IHI CPAM
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
601 W SPRUCE ST, SUITE A, MISSOULA, MT 59802-4057
(406) 329-2945
(406) 329-2938
Mailing address
PO BOX 34439, SEATTLE, WA 98124-1439
(406) 329-2945
(406) 329-2938
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
03/15/2011
Last updated
05/05/2025
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