Organization
PROVIDENCE HEALTH & SERVICES OREGON
Active
Other names
Providence Seaside Hospital Retail Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD W ANDERSON JR. (ASSISTANT SECRETARY ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
725 S WAHANNA RD, SEASIDE, OR 97138-7735
(503) 717-7380
Mailing address
PO BOX 31001-4199, PASADENA, CA 91110-4199
(503) 717-7380
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
RP-0001048-CS
OR
Other
Enumeration date
02/18/2014
Last updated
04/29/2025
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