Organization
SISTERS OF PROVIDENCE IN OREGON
Active
Parent organization
SISTERS OF PROVIDENCE IN OREGON
Other names
PMG SOUTH CARDIOVASCULAR SURGERY
Organization subpart
Yes
Provider details
NPI number
Legal business name
SISTERS OF PROVIDENCE IN OREGON
Authorized official
DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
940 ROYAL AVE, SUITE 450, MEDFORD, OR 97504-6193
(541) 732-7850
Mailing address
PO BOX 3319, MEDFORD, OR 97502-0012
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CG6801
RAIL ROAD MEDICARE
OR
Enumeration date
04/19/2007
Last updated
11/19/2025
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