Organization
PROVIDENCE HEALTH & SERVICES - OREGON
Active
Other names
Providence Medical Group Anticoagulation Telephone Management, PROVIDENCE MEDICAL GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY ENROLLMENT)
(425) 358-9786
Entity
Organization
Contact information
Practice address
3300 SE DWYER DR, SUITE 304, MILWAUKIE, OR 97222-6548
(503) 513-8043
Mailing address
PO BOX 31001 - 4180, PASADENA, CA 91110-4180
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
Primary
—
—
261Q00000X
Clinic/Center
—
—
Other
Enumeration date
07/03/2014
Last updated
06/20/2025
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