Organization
PROVIDENCE PHYSICIAN SERVICES CO.
Active
Parent organization
PROVIDENCE PHYSICIAN SERVICES CO.
Other names
PPS Providence Orthopedic Specialties
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVIDENCE PHYSICIAN SERVICES CO.
Authorized official
MR. MICHAEL J MALLORY (CREDENTIALING SPECIALIST)
(425) 525-6798
Entity
Organization
Contact information
Practice address
820 S MCCLELLAN, SUITE 300, PROVIDENCE ORTHOPEDIC SPECIALTIES, SPOKANE, WA 99204
(509) 464-7880
(509) 464-7961
Mailing address
PO BOX 34439, SEATTLE, WA 98124
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
08/03/2011
Last updated
08/03/2011
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