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Organization

PROVIDENCE HEALTH & SERVICES - OREGON

Active
Other names
PROVIDENCE NEWBERG ONCOLOGY & HEMATOLOGY CARE CLINIC, PROVIDENCE MEDICAL GROUP
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DONALD W ANDERSON JR. (ASSISTANT SECRETARY OF ENROLLMENTS)
(425) 358-9786
Entity
Organization

Contact information

Practice address
1003 PROVIDENCE DR, SUITE 310, NEWBERG, OR 97132-7524
(503) 537-6040
Mailing address
PO BOX 31001 - 4180, PASADENA, CA 91110-4180
(503) 215-6494

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
261Q00000X
Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500605162
OR
Enumeration date
02/18/2009
Last updated
06/20/2025
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