Organization
PROVIDENCE HEALTH & SERVICES - OREGON
Active
Organization
PROVIDENCE HEALTH & SERVICES - OREGON
Active
Other names
PROVIDENCE MEDICAL GROUP SOUTH, PMG Ashland
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD W ANDERSON JR. (ASSISTANT SECRETARY ENROLLMENT)
(425) 358-9786
Entity
Organization
Contact information
Practice address
1661 HIGHWAY 99 N, BUILDING A, SUITE 100, ASHLAND, OR 97520-8900
(541) 732-8300
(541) 732-8301
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(541) 732-8300
(541) 732-8301
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500661228
—
OR
Enumeration date
05/22/2013
Last updated
11/19/2025
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