Organization
PROVIDENCE HEALTH & SERVICES - OREGON
Active
Other names
PROVIDENCE MEDICAL GROUP, PMG MOLALLA
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
110 CENTER ST, MOLALLA, OR 97038-0189
(034) 053-7777
Mailing address
PO BOX 31001-4180, PASADENA, CA 91110-4180
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261Q00000X
Clinic/Center
—
—
Other
Enumeration date
10/14/2010
Last updated
06/20/2025
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