# PROVIDENCE HEALTH & SERVICES - OREGON

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Providence Occupational Medicine-Tanasbourne/Bridgeport
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306174438
- **Authorized official:** DONALD W ANDERSON JR. (REIMBURSEMENT DIRECTOR-ADMINISTRATI)
- **Authorized official phone:** (425) 525-5392

## Contact information

- **Practice address:** 18610 NW CORNELL RD, SUITE 204, HILLSBORO, OR 97124-9204
- **Practice address phone:** (503) 216-7960
- **Practice address fax:** (503) 216-0211
- **Mailing address:** PO BOX 4388, PORTLAND, OR 97208-4388
- **Mailing address phone:** (503) 216-7960
- **Mailing address fax:** (503) 215-6387

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QX0100X | Occupational Medicine Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/01/2009
- **Last updated:** 03/30/2017