Organization
PROVIDENCE HEALTH & SERVICES - OREGON
Active
Parent organization
PROVIDENCE HEALTH & SERVICES - OREGON
Other names
PROV HEALTH SYS-OR SHARED-SVS DIV, PROVIDENCE HOME MEDICAL EQUIPMENT
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVIDENCE HEALTH & SERVICES - OREGON
Authorized official
DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY OF ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
8605 COMMERCE PLACE DR NE STE A, LACEY, WA 98516-3813
(503) 215-4333
Mailing address
PO BOX 5936A, PORTLAND, OR 97228-5936
(503) 215-4663
(503) 215-4655
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
Other
Enumeration date
06/04/2021
Last updated
05/15/2025
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