Organization
PROVIDENCE HEALTH & SERVICES - OREGON
Active
Parent organization
PROVIDENCE HEALTH & SERVICES - OREGON
Other names
PMG NEWBERG SURGICAL SERVICES, PROVIDENCE MEDICAL GROUP
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVIDENCE HEALTH & SERVICES - OREGON
Authorized official
DONALD WAYNE ANDERSON JR. (ASSISTANT SECREATRY FOR ENROLLMENT)
(425) 358-9786
Entity
Organization
Contact information
Practice address
310 VILLA RD, SUITE 104, NEWBERG, OR 97132-1886
(503) 537-1508
Mailing address
PO BOX 31001 - 4180, PASADENA, CA 91110-4180
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
—
—
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
12/01/2006
Last updated
07/04/2025
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