Organization

Providence Health & Services - Oregon

Clinic/Center in Medford, OR(View on Map)

Legal Business Name

Providence Health & Services - Oregon

NPI Number

1710356001

NPI Type

Organization

Enumeration Date

09/17/2015

Specialties

(Taxonomies)

Code

261Q00000X

Primary Taxonomy

Yes

Contact
Information

Purpose

Mailing
Location

Address

PO BOX 3158
3225 HILLCREST PARK DRIVE

City

Portland
Medford

State

OR
OR

Postal Code

97208-3158
97504

Country

US
US

Telephone Number

(541) 734-3430
(541) 774-5700

Authorized Official

Name

Donald Anderson

Title or Position

ASST SECRETARY FOR ENROLLMENT

Telephone Number

(425) 525-5392

Identifiers

Identifier

500692785

Identifier State

OR

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 02/28/2018

Provider Address

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Specialty: Clinic/Center (Primary)

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Specialty: Clinic/Center (Primary)

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Specialty: Clinic/Center (Primary)

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Specialty: Clinic/Center (Primary)

Organization

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Specialty: Clinic/Center (Primary)

Organization

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Specialty: Clinic/Center (Primary)

Organization

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Specialty: Clinic/Center (Primary)

Organization

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Specialty: Clinic/Center (Primary)