# PROVIDENCE HEALTH & SERVICES OREGON

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PROVIDENCE MEDICAL GROUP, Providence OB Hospitalists PSVMC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235534116
- **Authorized official:** DONALD WAYNE ANDERSON JR. (ASST CORP SECRETARY FOR ENROLLMENTS)
- **Authorized official phone:** (425) 358-9786

## Contact information

- **Practice address:** 9205 SW BARNES RD, 3RD FLOOR MATERNITY - MT 3401, PORTLAND, OR 97225-6603
- **Practice address phone:** (503) 216-3388
- **Practice address fax:** (503) 216-7400
- **Mailing address:** PO BOX 31001 - 4180, PASADENA, CA 91110-4180

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/04/2014
- **Last updated:** 07/04/2025