Organization
PROVIDENCE HEALTH & SERVICES OREGON
Active
Other names
Providence Home Medical Equipment-Corvallis
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY OF ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
2296 NW KINGS BLVD STE 101, CORVALLIS, OR 97330-3871
(503) 215-4663
Mailing address
PO BOX 5936A, PORTLAND, OR 97228-5936
(503) 215-4663
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
03/07/2019
Last updated
05/15/2025
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