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Organization

PROVIDENCE HEALTH & SERVICES OREGON

Active
Parent organization
PROVIDENCE HEALTH & SERVICES OREGON
Other names
Providence Milwaukie Hospital
Organization subpart
Yes

Provider details

NPI number
Legal business name
PROVIDENCE HEALTH & SERVICES OREGON
Authorized official
DONALD W ANDERSON JR. (ASSISTANT SECRETARY ENROLLMENTS)
(425) 358-9786
Entity
Organization

Contact information

Practice address
10150 SE 32ND AVE, MILWAUKIE, OR 97222-6516
(503) 451-3000
Mailing address
PO BOX 31001-4199, PASADENA, CA 91110-4199
(503) 451-3000
(503) 215-0297

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
207P00000X
Emergency Medicine Physician
207R00000X
Internal Medicine Physician
207U00000X
Nuclear Medicine Physician
207V00000X
Obstetrics & Gynecology Physician
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
282N00000X
General Acute Care Hospital
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
050100000001
PROVIDENCE HEALTH PLAN
OR
01
138008200
REGENCE HOSPITAL NUMBER
OR
05
175620
OR
01
194589600
US DEPT. OF LABOR WC
OR
01
3003373
WASHINGTON MEDICAID
WA
01
95916
WA DEPT. OF LABOR
WA
01
C45062
RAILROAD MEDICARE
OR
Enumeration date
10/03/2006
Last updated
04/29/2025
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