Organization

Providence Health & Services Oregon

May also be knows as Providence Medical Group

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

Legal Business Name

Providence Health & Services Oregon

Also Known As

Providence Medical Group

NPI Number

1164623401

NPI Type

Organization

Enumeration Date

05/31/2007

Specialties

(Taxonomies)

Code

261Q00000X
104100000X

Primary Taxonomy

Yes
No

Contact
Information

Purpose

Mailing
Location

Address

PO BOX 3158
4400 NE HALSEY ST

City

Portland
Portland

State

OR
OR

Postal Code

97208-3158
97213-1545

Country

US
US

Telephone Number

N/A
(503) 893-6524

Authorized Official

Name

Donald Anderson

Title or Position

ASST CORP SEC FOR ENROLLMENTS

Telephone Number

(425) 525-5392

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

Data last updated by provider on 10/14/2022

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