Organization
PROVIDENCE HEALTH & SERVICES OREGON
Active
Other names
Providence Willamette Falls Child Adolescent Outpatient Psychiatry, PROVIDENCE MEDICAL GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD WAYNE ANDERSON JR. (ASST SECRETARY FOR ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
1511 DIVISION ST STE 101, OREGON CITY, OR 97045-1589
(503) 722-3705
(503) 722-3750
Mailing address
PO BOX 31001 - 4180, PASADENA, CA 91110-4180
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
08/21/2013
Last updated
07/04/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us