Organization
PROVIDENCE HEALTH & SERVICES - OREGON
Active
Other names
PROVDIENCE MEDICAL GROUP, Providence Medical Group Oregon City Pulmonary & Critical Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD W ANDERSON JR. (ASSISTANT SECRETARY FOR ENROLLMENT)
(425) 358-9786
Entity
Organization
Contact information
Practice address
1510 DIVISION ST, STE 170, OREGON CITY, OR 97045-2551
(503) 742-6700
(503) 742-6705
Mailing address
PO BOX 31001 - 4180, PASADENA, CA 91110-4180
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
—
—
261Q00000X
Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500618253
—
OR
Enumeration date
02/11/2010
Last updated
07/04/2025
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