Organization
PROVIDENCE HEALTH & SERVICES OREGON
Active
Other names
Prov Health Sys-OR Shared-Svs Div, Providence Occupational Medicine-Clackamas
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD WAYNE ANDERSON JR. (ASSISTANT SECREATRY FOR ENROLLMENT)
(425) 358-9786
Entity
Organization
Contact information
Practice address
9290 SE SUNNYBROOK BLVD, SUITE 210, CLACKAMAS, OR 97015
(503) 216-7960
(503) 216-2823
Mailing address
PO BOX 4388, PORTLAND, OR 97208-4388
(503) 216-7960
(503) 215-6387
Taxonomy
Speciality
Code
Description
License number
State
261QX0100X
Occupational Medicine Clinic/Center
Primary
—
—
Other
Enumeration date
12/01/2009
Last updated
07/08/2025
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