Organization
PROVIDENCE HEALTH & SERVICES OREGON
Active
Parent organization
PROVIDENCE HEALTH & SERVICES - OREGON
Other names
Providence Portland Medical Center
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
4805 NE GLISAN ST, PORTLAND, OR 97213-2933
(503) 215-4323
(503) 215-0297
Mailing address
PO BOX 3395, PORTLAND, OR 97208-3395
(503) 215-4323
(503) 215-0297
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
11/15/2006
Last updated
05/07/2025
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