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Organization
PROVIDENCE
Active
Organization
PROVIDENCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANICE BURGER (CEO)
(503) 216-1234
Entity
Organization
Contact information
Practice address
9427 SW BARNES RD, SUTIE 295, PORTLAND, OR 97225
(503) 216-3299
Mailing address
9205 SW BARNES RD, PORTLAND, OR 97225
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
NULL
Other
Enumeration date
05/10/2017
Last updated
05/10/2017
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