Organization
PROVIDENCE HEALTH & SERVICES - OREGON
Active
Other names
Providence Health Express at Gateway
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY ENROLLMENT)
(425) 358-9786
Entity
Organization
Contact information
Practice address
1321 NE 99TH AVE, SUITE 110A, PORTLAND, OR 97220-9436
(855) 229-6460
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
04/17/2014
Last updated
07/04/2025
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