Organization
PROVIDENCE HEALTH & SERVICES - OREGON
Active
Other names
Providence Occupational Medicine-Tanasbourne/Bridgeport
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD W ANDERSON JR. (REIMBURSEMENT DIRECTOR-ADMINISTRATI)
(425) 525-5392
Entity
Organization
Contact information
Practice address
18610 NW CORNELL RD, SUITE 204, HILLSBORO, OR 97124-9204
(503) 216-7960
(503) 216-0211
Mailing address
PO BOX 4388, PORTLAND, OR 97208-4388
(503) 216-7960
(503) 215-6387
Taxonomy
Speciality
Code
Description
License number
State
261QX0100X
Occupational Medicine Clinic/Center
Primary
—
—
Other
Enumeration date
12/01/2009
Last updated
03/30/2017
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