Organization
PROVIDENCE HEALTH & SERVICES - OREGON
Active
Other names
PROVIDENCE MEDICAL GROP, Providence Heart Clinic Hollywood, PROVIDENCE MEDICAL GROUP, Providence Heart Clinic at The Oregon Clinic Gateway
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY OF ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
4400 NE HALSEY ST STE 102, PORTLAND, OR 97213-1545
(503) 962-1000
Mailing address
PO BOX 31001 - 4180, PASADENA, CA 91110-4180
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
261Q00000X
Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Enumeration date
04/21/2011
Last updated
03/23/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us