Organization
PROVIDENCE HEALTH & SERVICES - OREGON
Active
Other names
PROVIDENCE MEDICAL GROUP, Providence Neurological Specialties Mill Plain
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD W ANDERSON JR. (ASSISTANT SECRETARY ENROLLMENT)
(425) 358-9786
Entity
Organization
Contact information
Practice address
315 SE STONEMILL DR, SUITE 220, VANCOUVER, WA 98684-6987
(503) 717-7147
Mailing address
PO BOX 31001 - 4180, PASADENA, CA 91110-4180
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
10/17/2014
Last updated
07/04/2025
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