Organization
PROVIDENCE HEALTH & SERVICES - OREGON
Active
Other names
PROVIDENCE MEDICAL GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD W ANDERSON JR. (ASST SEC ENROLL)
(425) 358-9786
Entity
Organization
Contact information
Practice address
440 NW DIVISION ST, GRESHAM, OR 97030-5506
(503) 215-9500
(503) 215-9525
Mailing address
PO BOX 31001 - 4180, PASADENA, CA 91110-4180
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
261Q00000X
Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
287333
—
OR
Enumeration date
09/20/2006
Last updated
06/20/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us