# PROVIDENCE HEALTH & SERVICES OREGON

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PROVIDENCE HEALTH & SERVICES OREGON
- **Other names:** Providence Seaside Hospital
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1558435362
- **Legal business name:** PROVIDENCE HEALTH & SERVICES OREGON
- **Authorized official:** DONALD W ANDERSON JR. (ASSISTANT SECRETARY ENROLLMENTS)
- **Authorized official phone:** (425) 358-9786

## Contact information

- **Practice address:** 725 S WAHANNA RD, SEASIDE, OR 97138-7735
- **Practice address phone:** (503) 717-7000
- **Mailing address:** PO BOX 31001-4199, PASADENA, CA 91110-4199
- **Mailing address phone:** (503) 215-4323
- **Mailing address fax:** (503) 215-0297

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 275N00000X | Medicare Defined Swing Bed Hospital Unit | — | NULL | Yes |

## Other

- **Enumeration date:** 11/20/2006
- **Last updated:** 04/29/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0000ZGBGT | PART B MEDICARE PTAN | OR |