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Organization
PROVIDENCE HEALTH & SERVICES-OREGON
Active
Organization
PROVIDENCE HEALTH & SERVICES-OREGON
Active
Other names
Providence Elder At Home
Organization subpart
No
Provider details
NPI number
Authorized official
MARK L METCALF (DIRECTOR OF FINANCE)
(503) 215-5491
Entity
Organization
Contact information
Practice address
4900 NE GLISAN ST, PORTLAND, OR 97213-2936
(503) 215-0750
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
OR
261Q00000X
Clinic/Center
—
OR
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
OR
Other
Enumeration date
04/21/2015
Last updated
04/21/2015
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