# PROVIDENCE HEALTH & SERVICES-OREGON

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Providence Child Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558689653
- **Authorized official:** DONALD W ANDERSON JR. (ASSISTANT SECRETARY OF ENROLLMENTS)
- **Authorized official phone:** (425) 358-9786

## Contact information

- **Practice address:** 830 NE 47TH AVE, ATTN: FINANCE, PORTLAND, OR 97213-2212
- **Practice address phone:** (503) 215-4483
- **Practice address fax:** (503) 215-0660
- **Mailing address:** 830 NE 47TH AVE, ATTN: FINANCE, PORTLAND, OR 97213-2212
- **Mailing address phone:** (503) 215-4483
- **Mailing address fax:** (503) 215-0660

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/13/2010
- **Last updated:** 05/16/2025