Organization
PROVIDENCE HEALTH & SERVICES - OREGON
Active
Other names
Providence Surgery Clinic Southeast, PROVIDENCE MEDICAL GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD W ANDERSON JR. (ASST SEC ENROLL)
(425) 525-5392
Entity
Organization
Contact information
Practice address
1510 DIVISION ST, SUITE 210, OREGON CITY, OR 97045-1599
(503) 723-6525
(503) 723-6508
Mailing address
PO BOX 31001 - 4180, PASADENA, CA 91110-4180
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
261Q00000X
Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500620076
—
OR
Enumeration date
02/11/2010
Last updated
06/30/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us