Organization
PROVIDENCE HEALTH & SERVICES OREGON
Active
Parent organization
PROVIDENCE HEALTH & SERVICES - OREGON
Other names
Providence Home Medical Equipment
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVIDENCE HEALTH & SERVICES - OREGON
Authorized official
DONALD W ANDERSON JR. (ASSISTANT SECRETARY OF ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
6410 NE HALSEY ST, SUITE 500, PORTLAND, OR 97213-4742
(503) 215-4663
(503) 215-4655
Mailing address
PO BOX 5936A, PORTLAND, OR 97228-5936
(503) 215-4663
(503) 215-4655
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
NPC-0002697
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
108837
—
OR
Enumeration date
10/13/2006
Last updated
05/15/2025
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