Organization
PROVIDENCE HEALTH & SERVICES OREGON
Active
Parent organization
PROVIDENCE HEALTH & SERVICES OREGON
Other names
Providence Seaside 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
725 S WAHANNA RD, SEASIDE, OR 97138-7735
(503) 717-7000
Mailing address
PO BOX 31001-4199, PASADENA, CA 91110-4199
(503) 215-4323
(503) 215-0297
Taxonomy
Speciality
Code
Description
License number
State
275N00000X
Medicare Defined Swing Bed Hospital Unit
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000ZGBGT
PART B MEDICARE PTAN
OR
Enumeration date
11/20/2006
Last updated
04/29/2025
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