Organization
PROVIDENCE HEALTH & SERVICES - OREGON
Active
Parent organization
PROVIDENCE HEALTH & SERVICES - OREGON
Other names
Providence Medical Group South
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVIDENCE HEALTH & SERVICES - OREGON
Authorized official
DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
1698 E MCANDREWS RD STE 160, MEDFORD, OR 97504-5590
(541) 732-6070
(541) 732-6005
Mailing address
PO BOX 31001 - 4180, PASADENA, CA 91110-4180
(425) 358-9786
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
261Q00000X
Clinic/Center
—
OR
Other
Enumeration date
02/22/2017
Last updated
11/19/2025
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