Organization
PROVIDENCE PORTLAND MEDICAL CENTER
Active
Parent organization
PROVIDENCE PORTLAND MEDICAL CENTER
Other names
PROVIDENCE HOSPITALISTS EAST
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVIDENCE PORTLAND MEDICAL CENTER
Authorized official
WILLIAM OLSON (CHIEF FINANCE OFFICER)
(503) 215-6241
Entity
Organization
Contact information
Practice address
4805 NE GLISAN ST, SUITE BG05, PORTLAND, OR 97213-2933
(503) 215-2392
Mailing address
PO BOX 3178, PORTLAND, OR 97208-3178
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
286612
—
OR
Enumeration date
04/02/2007
Last updated
10/30/2007
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