Organization
PROVIDENCE PHYSICIAN SERVICES CO
Active
Parent organization
PROVIDENCE PHYSICIAN SERVICES CO
Other names
PPS PROV FAMILY MED NORTHPOINT
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVIDENCE PHYSICIAN SERVICES CO
Authorized official
ANSELMO NUNEZ (CFO)
(509) 474-6616
Entity
Organization
Contact information
Practice address
212 E CENTRAL, STE 440, SPOKANE, WA 99208-6290
(509) 252-9602
Mailing address
101 W 8TH AVE, MOTHER GAMELIN CENTER, 3RD FLOOR, SPOKANE, WA 99204-2307
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
04/21/2010
Last updated
02/28/2011
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