Organization
PROVIDENCE HEALTH & SERVICES - OREGON
Active
Other names
Providence Health Express at Medford
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
1698 E MCANDREWS RD STE 170, MEDFORD, OR 97504-5590
(855) 229-6460
Mailing address
PO BOX 31001 - 4180, PASADENA, CA 91110-4180
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
02/10/2015
Last updated
07/04/2025
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