Organization
PROVIDENCE HEALTH & SERVICES- OREGON
Active
Other names
Providence Gorge Spine and Sports Medicine, 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
1627 WOODS CT, HOOD RIVER, OR 97031-2915
(541) 386-9511
Mailing address
PO BOX 31001 - 4180, PASADENA, CA 91110-4180
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
2251S0007X
Sports Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
12/16/2014
Last updated
03/23/2026
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