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General NPI Number Information
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NPI Number | 1457487019
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Entity Type | Organization
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Legal Business Name | ST. PATRICK HOSPITAL & HEALTH SCIENCES CENTER
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 601 W SPRUCE ST SUITE D
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City | MISSOULA
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State | MT
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Zip | 59802-4057
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Country | US
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Telephone | 406-728-7388
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Fax | 406-329-2923
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Provider Business Mailing Address
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Address Line | 601 W SPRUCE ST SUITE D
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City | MISSOULA
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State | MT
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Zip | 59802-4057
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Country | US
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Telephone | 406-728-7388
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Fax | 406-329-2923
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Authorized Official
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Title or Position | ASSISTANT SECRETARY ENROLLMENT
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Name | DONALD WAYNE ANDERSON JR.
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Credential |
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Telephone | 425-358-9786
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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