Organization
PROVIDENCE HEALTH & SERVICES
Active
Other names
PROVIDENCE MEDICAL GROUP, PMG/Oregon City
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD WAYNE ANDERSON JR. (ASST SEC ENROLLMENT)
(425) 358-9786
Entity
Organization
Contact information
Practice address
1510 DIVISION ST STE 200, OREGON CITY, OR 97045-1599
(503) 650-6880
(503) 650-6888
Mailing address
PO BOX 31001 - 4180, PASADENA, CA 91110-4180
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
067983
—
OR
Enumeration date
05/21/2007
Last updated
06/20/2025
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