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Organization
PROVIDENCE HEALTH & SERVICES - OREGON
Active
Organization
PROVIDENCE HEALTH & SERVICES - OREGON
Active
Parent organization
PROVIDENCE HEALTH & SERVICES - OREGON
Other names
PROVIDENCE MEDICAL GROUP, PROVIDENCE MULTIPLE SCLEROSIS CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVIDENCE HEALTH & SERVICES - OREGON
Authorized official
DONALD WAYNE ANDERSON JR. (ASSISTANT SECREATRY FOR ENROLLMENT)
(425) 358-9786
Entity
Organization
Contact information
Practice address
9427 SW BARNES RD, STE 595, PORTLAND, OR 97225-6652
(503) 296-9242
(503) 296-9856
Mailing address
PO BOX 31001 - 4180, PASADENA, CA 91110-4180
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
261Q00000X
Clinic/Center
—
NULL
Other
Enumeration date
01/11/2008
Last updated
06/20/2025
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