Organization
PROVIDENCE HEALTH & SERVICES OREGON
Active
Other names
Providence Seaside Hospital, Providence Cannon Beach Clinic, PROVIDENCE SEASIDE HOSPITAL - PROVIDENCE CANNON BEACH CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD W ANDERSON JR. (ASSISTANT SECRETARY ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
171 N LARCH ST STE 16, CANNON BEACH, OR 97110-3103
(503) 717-7400
Mailing address
PO BOX 31001-4199, PASADENA, CA 91110-4199
(503) 893-7120
(425) 276-3215
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
02/15/2019
Last updated
04/29/2025
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