# PROVIDENCE HEALTH & SERVICES- OREGON

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Providence Gorge Spine and Sports Medicine, Providence Medical Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609274133
- **Authorized official:** MR. DONALD W ANDERSON JR. (ASSISTANT SECRETARY OF ENROLLMENTS)
- **Authorized official phone:** (425) 358-9786

## Contact information

- **Practice address:** 1627 WOODS CT, HOOD RIVER, OR 97031-2915
- **Practice address phone:** (541) 386-9511
- **Mailing address:** PO BOX 31001 - 4180, PASADENA, CA 91110-4180

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |
| 2251S0007X | Sports Physical Therapist | — | NULL | — |
| 2251S0007X | Sports Physical Therapist | — | — | — |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |

## Other

- **Enumeration date:** 12/16/2014
- **Last updated:** 03/23/2026