Organization
PROVIDENCE HEALTH & SERVICES MT
Active
Parent organization
PROVIDENCE HEALTH & SERVICES
Other names
SPH First Step
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVIDENCE HEALTH & SERVICES
Authorized official
DONALD WAYNE ANDERSON JR. (ASSISTNAT SECRETARY ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
900 N ORANGE ST, SUITE 107, MISSOULA, MT 59802-2951
(406) 329-5776
Mailing address
PO BOX 34439, SEATTLE, WA 98124-1439
(406) 329-5776
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
06/02/2009
Last updated
05/07/2025
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