Organization
PROVIDENCE ST VINCENT MEDICAL CENTER
Active
Parent organization
PROVIDENCE ST VINCENT MEDICAL CENTER
Other names
PROVIDENCE INTEGRATIVE MEDICINE WEST
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVIDENCE ST VINCENT MEDICAL CENTER
Authorized official
DENNIS NOONAN (CHIEF FINANCE OFFICER)
(503) 216-4657
Entity
Organization
Contact information
Practice address
9135 SW BARNES RD, SUITE 161, PORTLAND, OR 97225-6601
(503) 216-0246
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
06/04/2009
Last updated
06/04/2009
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