Organization
PROVIDENCE HEALTH & SERVICES - OREGON
Active
Parent organization
PROVIDENCE PORTLAND MEDICAL CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVIDENCE PORTLAND MEDICAL CENTER
Authorized official
DONALD W ANDERSON JR. (ASSISTANT SECRETARY ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
2705 E BURNSIDE ST, SUITE 114, PORTLAND, OR 97214-1763
(503) 215-6262
(503) 234-5437
Mailing address
PO BOX 3395, PORTLAND, OR 97208-3395
(503) 215-4323
(503) 215-0297
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
054002
—
OR
01
—
824986000
REGENCE CLINIC NUMBER
OR
Enumeration date
02/27/2007
Last updated
05/07/2025
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