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Organization
PROVIDENCE PORLAND MEDICAL CENTER
Active
Organization
PROVIDENCE PORLAND MEDICAL CENTER
Active
Other names
Providence Health System
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERRI LYNN EELLS (RN/NURSE PRACTITIONER STUDENT)
15032156150
Entity
Organization
Contact information
Practice address
4805 NE GLISAN ST, PORTLAND, OR 97213-2933
(503) 215-1111
Mailing address
312 ENGLE AVE, MOLALLA, OR 97038-9138
(150) 335-1019
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
09000464RN
OR
Other
Enumeration date
08/27/2007
Last updated
08/27/2007
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