Organization
PROVIDENCE HEALTH & SERVICES MT
Active
Parent organization
PROVIDENCE HEALTH & SERVICES
Other names
PROVIDENCE MEDICAL GROUP MONTANA, PMG MT IHI Montana Cardiology
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVIDENCE HEALTH & SERVICES
Authorized official
DONALD W ANDERSON JR. (ASSISTANT SECRETARY ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
2829 GREAT NORTHERN LOOP, SUITE 300, MISSOULA, MT 59808-1752
(406) 541-7000
Mailing address
PO BOX 31001 - 4114, PASADENA, CA 91110-4114
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
—
—
Other
Enumeration date
08/03/2009
Last updated
05/07/2025
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