# PROVIDENCE HEALTH & SERVICES OREGON

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Providence Seaside Hospital Retail Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669896270
- **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) 717-7380
- **Mailing address:** PO BOX 31001-4199, PASADENA, CA 91110-4199
- **Mailing address phone:** (503) 717-7380

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | RP-0001048-CS | OR | Yes |

## Other

- **Enumeration date:** 02/18/2014
- **Last updated:** 04/29/2025