Providence Health & Services - Oregon
May also be knows as Providence Peds Spec Mjp
Clinic/Center in Portland, OR(View on Map)
Legal Business Name
Providence Health & Services - Oregon
Also Known As
Providence Peds Spec Mjp
NPI Number
1033299458
NPI Type
Organization
Enumeration Date
10/17/2006
Specialties
(Taxonomies)Contact
Information
Purpose
Mailing
Location
Address
PO BOX 3158
9427 SW BARNES RD
City
Portland
Portland
State
OR
OR
Postal Code
97208-3158
97225-6652
Country
US
US
Telephone Number
(503) 215-6494
(503) 216-8654
Authorized Official
Name
Mr. Donald Anderson
Title or Position
DIR REIMB REG STRAT/ASST SEC ENROLL
Telephone Number
(425) 525-5392
Identifiers
Identifier
022858
Identifier State
OR
Identifier Issuer
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 11/04/2021
Provider Address
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