Organization
PROVIDENCE HEALTH & SERVICES - OREGON
Active
Other names
Providence Hood River ENT, PROVIDENCE MEDICAL GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD W ANDERSON JR. (ASSISTANT SECRETARY ENROLLMENT)
(425) 358-9786
Entity
Organization
Contact information
Practice address
1619 WOODS CT, HOOD RIVER, OR 97031-2915
(541) 386-5119
(541) 386-3061
Mailing address
PO BOX 31001 - 4180, PASADENA, CA 91110-4180
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500650973
—
OR
Enumeration date
09/18/2012
Last updated
07/04/2025
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