| Providence Medical Group Mill Plain Xray | |
|
315 Se Stone Mill Dr Suite 102 Vancouver WA 98684-6998 | |
| (360) 816-2700 | |
| (360) 816-2710 |
| Full Name | Providence Medical Group Mill Plain Xray |
|---|---|
| Speciality | Clinic/center |
| Location | 315 Se Stone Mill Dr, Vancouver, Washington |
| Authorized Official Name and Position | Donald W Anderson (DIR REIMB REG STRAT/ASST SEC ENROLL) |
| Authorized Official Contact | 4255255392 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Medical Group Mill Plain Xray Po Box 3158 Portland OR 97208-3158 Ph: () - | Providence Medical Group Mill Plain Xray 315 Se Stone Mill Dr Suite 102 Vancouver WA 98684-6998 Ph: (360) 816-2700 |
| NPI Number | 1982026241 |
|---|---|
| Provider Enumeration Date | 01/06/2014 |
| Last Update Date | 02/21/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982026241 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| 261QR0200X | Clinic/center - Radiology | (* (Not Available)) | Secondary |
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