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Organization
PROVIDENCE HEALTH & SERVICES - OREGON
Active
Organization
PROVIDENCE HEALTH & SERVICES - OREGON
Active
Parent organization
PROVIDENCE HEALTH & SERVICES - OREGON
Other names
Providence Medford Medical Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVIDENCE HEALTH & SERVICES - OREGON
Authorized official
DONALD W ANDERSON JR. (ASSISTANT SECRETARY ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
1111 CRATER LAKE AVE, MEDFORD, OR 97504-6241
(503) 451-3000
(503) 215-0290
Mailing address
PO BOX 31001-4199, PASADENA, CA 91110-4199
(503) 451-3000
(503) 215-0290
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
NULL
207L00000X
Anesthesiology Physician
—
—
207P00000X
Emergency Medicine Physician
—
NULL
207P00000X
Emergency Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207U00000X
Nuclear Medicine Physician
—
NULL
207U00000X
Nuclear Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
NULL
207V00000X
Obstetrics & Gynecology Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
NULL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
—
282N00000X
General Acute Care Hospital
Primary
—
NULL
Other
Enumeration date
10/18/2006
Last updated
05/27/2025
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