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Organization

PROVIDENCE HEALTH & SERVICES - OREGON

Active
Other names
Providence Health Express at Bridgeport, PROVIDENCE MEDICAL GROUP
Organization subpart
No

Provider details

NPI number
Authorized official
KEENAN B FREEMAN (CFO)
(503) 893-6524
Entity
Organization

Contact information

Practice address
18040 SW LOWER BOONES FERRY RD, SUITE 104, PORTLAND, OR 97224-7259
(855) 229-6490
Mailing address
PO BOX 31001 - 4180, PASADENA, CA 91110-4180

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary

Other

Enumeration date
04/18/2014
Last updated
06/20/2025
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