PROVIDENCE HEALTH & SERVICES - OREGON

PORTLAND, OR
NPI1679678866
Doing Business AsPROVIDENCE MEDICAL GROUP
Doing Business AsPROVIDENCE MEDICAL GROUP SOUTHEAST FAMILY MEDICINE
Entity TypeOrganization
Authorized ContactDONALD WAYNE ANDERSON
Asst Sec Enroll
425-358-9786
Organization Subpart ?No
Primary Taxonomy207Q00000X Family Medicine
Additional Taxonomies103T00000X Psychologist
261Q00000X Clinic/Center
Enumeration Date2006-09-13
Last Update Date2025-06-30
Business Address
PROVIDENCE HEALTH & SERVICES - OREGON
4104 SE 82ND AVE SUITE 250
PORTLAND, OR 97266-2954
Phone number: 503-215-9850
Mailing Address
PROVIDENCE HEALTH & SERVICES - OREGON
PO BOX 31001 - 4180
PASADENA, CA 91110-4180
Phone number: