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Organization
PROVIDENCE HEALTH & SERVICES OREGON
Active
Organization
PROVIDENCE HEALTH & SERVICES OREGON
Active
Other names
Providence Connections Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
6410 NE HALSEY ST, SUITE 300, PORTLAND, OR 97213-4749
(503) 215-4691
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
—
NULL
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
—
—
261Q00000X
Clinic/Center
—
NULL
261Q00000X
Clinic/Center
—
OR
Other
Enumeration date
01/25/2007
Last updated
05/16/2025
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