| Providence St Peter Internal Medi | |
|
3425 Ensign Rd Ne Suite 220 Olympia WA 98506-5063 | |
| (360) 491-1112 | |
| Not Available |
| Full Name | Providence St Peter Internal Medi |
|---|---|
| Speciality | Internal Medicine |
| Location | 3425 Ensign Rd Ne, Olympia, Washington |
| Authorized Official Name and Position | Nicole Quinn (PAYOR CREDENTIALING MANAGER) |
| Authorized Official Contact | 4255256715 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence St Peter Internal Medi Po Box 34439 Seattle WA 98124-1439 Ph: (425) 525-6778 | Providence St Peter Internal Medi 3425 Ensign Rd Ne Suite 220 Olympia WA 98506-5063 Ph: (360) 491-1112 |
| NPI Number | 1710161344 |
|---|---|
| Provider Enumeration Date | 12/18/2007 |
| Last Update Date | 12/22/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710161344 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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