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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 WAYNE ANDERSON JR. (ASSISTANT SECRETARY ENROLLMENTS)
(425) 358-9786
Entity
Organization

Contact information

Practice address
2508 PRINGLE RD SE, SALEM, OR 97302-1532
(503) 585-4027
(503) 585-4741
Mailing address
PO BOX 5936A, PORTLAND, OR 97228-5936
(503) 215-4663
(503) 215-4778

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
332BX2000X
Oxygen Equipment & Supplies (DME)
NPC-0003127
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
270998
OR
Enumeration date
08/27/2007
Last updated
05/16/2025
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