Organization
PROVIDENCE HEALTH & SERVICES - OREGON
Active
Other names
PROVIDENCE MEDICAL GROUP, Providence West Oncology Palliative Care Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY ENROLLMENT)
(425) 358-9786
Entity
Organization
Contact information
Practice address
9135 SW BARNES RD, SUITE 261, PORTLAND, OR 97225-6784
(503) 215-1350
(503) 215-1349
Mailing address
PO BOX 31001 - 4180, PASADENA, CA 91110-4180
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
—
—
207RX0202X
Medical Oncology Physician
Primary
—
—
261Q00000X
Clinic/Center
—
—
Other
Enumeration date
05/10/2013
Last updated
06/20/2025
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