PROVIDENCE HEALTH & SERVICES - OREGON

PORTLAND, OR
NPI1407109937
Doing Business AsPROVIDENCE MEDICAL GROUP
Doing Business AsPROVIDENCE ORAL HEAD AND NECK CLINIC
Entity TypeOrganization
Authorized ContactDONALD WAYNE ANDERSON
Assistant Secretary Enrollment
425-358-9786
Organization Subpart ?No
Primary Taxonomy204E00000X Oral & Maxillofacial Surgery
Additional Taxonomies261Q00000X Clinic/Center
Enumeration Date2012-10-22
Last Update Date2025-07-04
Business Address
PROVIDENCE HEALTH & SERVICES - OREGON
4805 NE GLISAN ST SUITE 6N50
PORTLAND, OR 97213-2933
Phone number: 503-215-3053
Mailing Address
PROVIDENCE HEALTH & SERVICES - OREGON
PO BOX 31001 - 4180
PASADENA, CA 91110-4180
Phone number: