Organization
PROVIDENCE HEALTH & SERVICES OREGON
Active
Parent organization
PROVIDENCE HEALTH & SERVICES OREGON
Other names
Providence Transitions-The Mary Clark Appearance Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVIDENCE HEALTH & SERVICES OREGON
Authorized official
DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY ENROLLMENT)
(425) 358-9786
Entity
Organization
Contact information
Practice address
4805 NE GLISAN ST, CANCER CENTER 1ST FLOOR, PORTLAND, OR 97213-2933
(503) 215-8998
(503) 215-3201
Mailing address
PO BOX 5936 A, PORTLAND, OR 97228-5936
(503) 215-8998
(503) 215-3201
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
04/29/2008
Last updated
05/16/2025
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