Organization
PROVIDENCE HEALTH & SERVICES - OREGON
Active
Other names
PROVIDENCE MEDICAL GROUP, PROVIDENCE MEDICAL GROUP ARTHRITIS CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD W ANDERSON JR. (ASST SEC ENROLL/EVP)
(425) 525-5392
Entity
Organization
Contact information
Practice address
5050 NE HOYT ST, SUITE 155, PORTLAND, OR 97213-2956
(503) 215-6879
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
210638
—
OR
Enumeration date
05/13/2009
Last updated
06/07/2024
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