Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Providence Health & Services Mt

Organization Spinal Cord Injury Medicine Physician · NPI 1063653897

Providence Health & Services Mt is a Spinal Cord Injury Medicine Physician in Missoula, Montana. Registered with an NPI since 2009.

In the registry since
2009
Specialties on file
2

Practice location Address checks out

500 W Broadway St 3rd Fl
Missoula, MT 59802-4096
Phone: (406) 327-1670
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Spinal Cord Injury Medicine Physician (primary) Taxonomy 2081P0004X
Pain Clinic/Center Taxonomy 261QP3300X

Record details

NPI number1063653897
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationProvidence Health & Services
Authorized official Donald Anderson — Assistant Secretary Enrollment · (425) 358-9786
Other names Pmg Mt Spine & Pain; Pmg Mt Spine & Pain; Providence Medical Group Montana
NPI enumeratedMarch 6, 2009
Last updated in NPPESMay 6, 2025
Certification dateMay 6, 2025
Mailing addressPo Box 31001 - 4114, Pasadena, CA 91110-4114