Providence Health & Services Oregon
May also be knows as Providence Connections Medical Group
Clinic/Center in Portland, OR(View on Map)
Legal Business Name
Providence Health & Services Oregon
Also Known As
Providence Connections Medical Group
NPI Number
1043366172
NPI Type
Organization
Enumeration Date
01/25/2007
Specialties
(Taxonomies)Contact
Information
Purpose
Mailing
Location
Address
PO BOX 3158
6410 NE HALSEY ST
City
Portland
Portland
State
OR
OR
Postal Code
97208-3158
97213-4749
Country
US
US
Telephone Number
(503) 215-6494
(503) 215-4691
Authorized Official
Name
Mr. Donald Anderson
Title or Position
ASST SEC FOR ENROLL/DIR REIMB ADMIN
Telephone Number
(425) 525-5392
Identifiers
Identifier
247685
Identifier State
OR
Identifier Issuer
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 07/08/2020
Provider Address
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